Evaluation of tubal patency by sonosalpingography is as good as hysterosalpingography in infertile women


  • C. Santhana Lakshmi Department of Obstetrics and Gynecology, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Madhurantagam, Tamil Nadu, India
  • Kumara Sampath Department of Radiodiagnosis, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Madhurantagam, Tamil Nadu, India
  • Parvatha Vardani Department of Obstetrics and Gynecology, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Madhurantagam, Tamil Nadu, India




Hysterosalpingography, Infertility, Radiodiagnosis, Sonosalpingography, Tubal patency


Background: Tubal pathology is one of the causes of infertility in sub fertile couples. Therefore, evaluation of fallopian tubes forms an essential part of evaluation in a sub fertile woman. The aim of the study was to compare the efficacy of sonosalpingography which is a less invasive method when compared to hysterosalpingogram for evaluation of utero-tubal factor in females.

Methods: A total of 95 patients 69 with primary infertility and 26 with secondary infertility attending our Obstetrics and Gynecology department were recruited for the study from June 2016 to July 2017. All the study subjects underwent Sonosalpingography on day 5th to 7th and Hysterosalpingography on 7th to 9th day of the menstrual cycle. Data was collected and compared to assess the sensitivity and specificity of sonosalpingography over hysterosalpingography. Statistical analysis was done by using SPSS software version 16.0.

Results: Sonosalpingography (SSG) has 97% sensitivity and 94% specificity in comparison to hysterosalpingography (HSG). Analysis of the raw data gave positive predictive value of 98.3% and negative predictive value of 75%. From the results of this study it clear that there is no statistically significant difference (p = 0.237) between the results of the two methods (SSG and HSG).

Conclusions: As sonosalpingogrpahy has high sensitivity and specificity and is less invasive. It should be used initially to assess tubal patency in cases of infertility. SSG is found to be a reliable, relatively less expensive diagnostic and therapeutic procedure in the management of infertility in females. Easy availability and accessibility of ultrasound in all primary health care centers definitely can prove superior to conventional method of diagnosis of tubal patency in such patient.


Kulkarni NN, Patel R, Patel NR, Patil AB. Comparative study of sonosalpingography versus hysterosalpingography for tubal patency test. Int J Reprod Contracept Obstet Gynecol. 2016;5:3300-3.

Laurence AM, Michael RS. Infertility evaluation and treatment. In: Imaging of the Reproductive Tract in Infertile Women: Hysterosalpingography, Ultrasonography and Magnetic Resonance Imaging. WB Saunders Company;1995:300-3. Chapter 23.

Bayasgalan G, Naranbat D, Tsedmaa B, Tsogmaa B, Sukhee D, Amarjargal O et al. Clinical patterns and major causes of infertility in Mongolia. J Obstet Gynecol Res. 2004;30:386-393.

Chiamchanya C, Su-angkawatin W. Study of the causes and the results of treatment in infertile couples at Thammasat Hospital between 1999-2004. J Med Assoc Thailand. 2008;91:805-812.

Stewart-Smythe GW, van Iddekinge B. Lessons learned from infertility investigations in the public sector. S Afr Med J. 2003;3:141-3.

Steven RG. Saline infusion sonohysterography. Clin Obst Gynecol. 2000;39(1):248-258.

Farhi J, Ben-Haroush A. Distribution of causes of infertility in patients attending primary fertility clinics in Israel. IMAJ. 2011;13:51-54.

Rao KS. Text Book of Diagnostic Radiology and Imaging. 1st ed. India: Jaypee Publications;1997.

Kore S, Hegde A, Nair S. Sonography for assessment of tubal potency: our experience. J Obstet Gynecol India. 2000;50(2):636.

Panchal S, Nagori C. Imaging techniques for assessment of tubal status. J Hum Reprod Sci. 2014;7:2-12.

Rahman M, Sinha DK. A cost-effective approach in the evaluation of female infertility. Obstet Gynecol Ind. 2002;52(1):105-7.

Sergio RS, Marcos MBBdR, Aroldo FC. Diagnostic accuracy of sonohysterography, transvaginal sonography and hysterosalpingography in patients with uterine cavity diseases. Fertil Steril. 2000;73(2):406-411.

Saanida MP, Beenamol S. A comparative study between sonohysterosalpingography and hysterosalpingography in the evaluation of infertility. J Evol Med Dent Sci. 2013 Feb 18;2(7):702-9.

Allabadia GN. Fallopian tubes and ultrasonography: the Sion experience. Fertil Steril. 1992;58:901-7.

Deichert U. Evaluation of tubal patency by hysterosalpingocontrastsonography (HYCOSY). In: Kupesie S. Ziegler D. (eds). Ultrasound and Infertility. New York The Parthenon publishing group;2000:263-284.

Diaferia D, Ragni G, Vegetti. Sonohysterography for uterine cavity evaluation in infertility work-up. Fertil Steril. 2000;74(3):530.

Johnson N, Vandekerckhove P, Watson A, Lilford R, Harada T, Hughes E. Tubal flushing for subfertility. Cochrane Database Syst Rev. 2005:CD003718.

Parihar M. Transcervical tubal evaluation. In: Infertility Principles and Practice. New Delhi, India: B. I. Publications, Pvt. Ltd;2004:44-49.

Shailesh K, Aparna H, Sudha N. Sonosalpingography for assessment of tubal patency: our experience. J Obstet Gynecol India. 2000;50(2):63-66.






Original Research Articles