Assessment of Tubal Patency by Sonohystrography in Infertile Women
Iraqi Postgratuate Medical Journal,
2019, Volume 18, Issue 2, Pages 154-160
Tubal problem is one of the causes of infertility in infertile couples. For that, evaluation of fallopian tubes forms an important part of evaluation in infertile woman.
To assess the diagnostic accuracy of Sonohysterography (SHG) in comparison with hysterosalpingography (HSG) in infertile women.
PATIENTS AND METHODS:
this cross sectional study included 50 women, 37women with primary infertility and 13women with secondary infertility. The study was conducted in Al-Imamian Al-Kadhimian medical city/Baghdad/Iraq from 1st of October 2017 to 30th of July 2018. All underwent clinical and physical examination. This was followed by Sonohysterography on day 7th or 8th of menstrual cycle and Hysterosalpingography on the same day.
Fifty infertile women were included in this study with mean age of 27.9±5.9 years. Mean infertility duration of studied women was 3.6±2.4 years; 68% (N=34) of infertile women had duration of less than 5 years and 32% (N=16) of them had duration of 5 years and more. The history of previous surgical operation was detected in 28% (N=14) of infertile women. The final diagnosis of hysterosalpingography (SHG) revealed that 89% (N=89) patent fallopian tubes and 11% (N=11) obstructed tubes. The final hysterosalpingography (HSG) revealed that 85% (N=85) patent fallopian tubes and 15% (N=15) obstructed tubes. No significant difference between women with patent and obstructed fallopian tube by SHG regarding history of parity (p=0.6), abortion (p=0.7), type of infertility (p=0.1), infertility duration (p=0.6), history of previous operation (p=0.5) and history of previous diagnostic intervention (p=0.6). Sonohysterography (SSG) has 100 % sensitivity and 60 % specificity in comparison to hysterosalpingography (HSG). Analysis of the raw data gave positive predictive value of 95.7% and negative predictive value of 100 %. From the results of this study it clear that there is no statistically significant difference (p = 0.001) between the results of the two methods (SSG and HSG) with an accuracy of 96%.
Sonohysterography has higher sensitivity and good specificity and is lesser invasive. It can be used primarily to assess tubal condition in infertile women.
KEYWORDS: Sonohysterography (SHG), infertile women
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