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. 2022 Jun 13:10:20503121221104434.
doi: 10.1177/20503121221104434. eCollection 2022.

Correlation between hysterosalpingography diagnosis and final hysterolaparoscopy with dye-test diagnosis in women with utero-tubal infertility: A cross-sectional study of the implication for which test should be the first-line investigation

Emeka Philip Igbodike  1 , Olusegun Olalekan Badejoko  1   2 , Olusola Benjamin Fasubaa  1   2 , Bolanle Olubunmi Ibitoye  3   4 , Olabisi Morebise Loto  1   2 , Joseph Ifeanyichukwu Ikechebelu  5   6 , George Uchenna Eleje  5   6 , Arinze Anthony Onwuegbuna  7 , Boniface Chukwuneme Okpala  5   6 , Osita Samuel Umeononihu  5   6 , Onyecherelam Monday Ogelle  5   6
Affiliations

Correlation between hysterosalpingography diagnosis and final hysterolaparoscopy with dye-test diagnosis in women with utero-tubal infertility: A cross-sectional study of the implication for which test should be the first-line investigation

Emeka Philip Igbodike et al. SAGE Open Med. .

Abstract

Objective: To assess the accuracy of hysterosalpingography in diagnosis of uterine and/or tubal factor infertility, using hysterolaparoscopy with dye test as the gold standard with an implication for which test should be the first-line investigation.

Methods: A prospective cross-sectional study of 96 women who underwent hysterosalpingography and hysterolaparoscopy with dye test. All women within reproductive age group with utero-tubal infertility who underwent both hysterosalpingography and hysterolaparoscopy with dye-test procedure were included. The outcome measures were proportions of tubal blockage and intrauterine pathology. Individual and overall mean accuracy were calculated for hysterosalpingography, using hysterolaparoscopy with dye test as the gold standard. Patient had procedure of hysterosalpingography first and both laparoscopic surgeons and patients were blinded to the outcome of hysterolaparoscopy with dye test until analysis. Statistical significance was set at p < 0.05.

Results: Overall, 128 women were assessed for eligibility while 96 women finally completed the study. Hysterosalpingography demonstrated diagnostic accuracy of 77.8% (p < 0.001), 76.3% (p < 0.001) and 78.3% (p < 0.001) for right, left and bilateral tubal blockage, respectively. Overall accuracy of hysterosalpingography tubal factor assessment was 77.4 ± 0.8% (95% confidence interval = 76.5% to 78.4%). Hysterosalpingography showed an accuracy of 85.7%, 86.6% and 76.7% for right, left and bilateral hydrosalpinx, respectively, given overall diagnostic accuracy of 83.0 ± 5.1% (95% confidence interval = 77.9% to 88.1%). Overall accuracy of hysterosalpingography in diagnosing intrauterine pathology was 68.5 ± 9.8% (95% confidence interval = 53.9% to 83.1%).

Conclusion: Hysterosalpingography detects tubal blockade and intrauterine pathology poorly compared to hysterolaparoscopy with dye test. Hysterosalpingography may face unpredictable clinical situations biased by technological error, leading to unsuccessful evaluation and uncertain diagnosis. Although the cost-effectiveness, risk of surgery or anaesthesia flaws hysterolaparoscopy with dye test. Hysterosalpingography should not be the first-line utero-tubal assessment tool rather hysterolaparoscopy with dye test.

Keywords: Agreement; patency; predictive values; sensitivity; specificity; tubal blockage; uterine pathology.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
STARD flow diagram of HSG versus HLD study.
See this image and copyright information in PMC

References

    1. Olawale BB, Ademola AO, Gbadebo AGO. Tubal abnormalities in patients with intrauterine adhesion: evaluation using hysterosalpingography. Ann Afr Med 2014; 13(4): 179–183. - PubMed
    1. Olaleye O, Olamijulo JA. The value of chlamydial antibody level for predicting tubal blockage among women undergoing hysterosalpingography in Lagos, Nigeria. Int J Gynaecol Obstet 2016; 134(1): 33–36. - PubMed
    1. Ahmed S, Parvin S, Shaha DR, et al.. Clinical profile of pelvic inflammatory disease (PID). Faridpur Med Coll J 2017; 12(1): 25–30.
    1. Djuwantono T, Permadi W, Septiani L, et al.. Female genital tuberculosis and infertility: serial cases report in Bandung, Indonesia and literature review. BMC Res Notes 2017; 10(1): 683. - PMC - PubMed
    1. Kachhawa G, Singh A. Evaluation of the infertile female. Indian J Clin Pract 2019; 30(2): 120–124.

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