Diagnostic value of sonohysterography in the determination of fallopian tube patency as an initial step of routine infertility assessment

Abstract

Objectives: Infertility is defined as the failure to conceive after 1 year of regular unprotected intercourse. It affects 10% to 15% of couples. Sonohysterography (SHG) is an accurate method for the assessment of fallopian tube patency, reflected in its high positive predictive value compared with hysterosalpingography (HSG) and laparoscopy with chromopertubation. In this study, our goal was to determine the diagnostic value of SHG for the diagnosis of bilateral tubal obstruction by comparison of SHG with HSG and laparoscopic results.

Methods: This study was based on the evaluation of tubal patency by SHG and by the combination of HSG and laparoscopy in 40 patients. All patients underwent HSG as a routine infertility workup, and all patients with bilateral proximal tubal obstruction diagnosed by HSG subsequently underwent SHG.

Results: Among 1024 infertile women referred to an infertility clinic, 117 (11.4%) had a diagnosis of a tubal factor as the cause of their infertility. Forty-two patients with HSG findings of bilateral proximal tubal obstruction were enrolled. Forty patients underwent SHG. In 32 patients (80%), at least 1 fallopian tube was patent, and 8 patients (20%) were reported to have bilateral tubal obstruction. Those 8 patients with SHG evidence of bilateral tubal obstruction underwent laparoscopy. Eventually, 6 of those were laparoscopically confirmed to have bilateral tubal obstruction.

Conclusions: Sonohysterography is an accurate method for the determination of fallopian tube patency. It is a simple, safe, and well-tolerated technique with a low risk of adverse effects and severe complications.