DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20181362

Hysterosalpingography (HSG), hysteroscopy and laparoscopic evaluation of female genital tract of patient attending tertiary infertility centre and correlation of various modalities

G. D. Maiti, Prasad Lele

Abstract


Background: Hysterosalpingogarphy (HSG) has traditionally been the first line of investigation anatomy and contour of uterine cavity along with fallopian tube and its patency. Because of limitations of HSG, video endoscopic evaluation of endometrial and peritoneal cavity by diagnostic hysteroscopy and laparoscopy can diagnose many subtle and obvious pathologies in evaluation of infertile couple. To know this difference author studied the efficacy of HSG along with diagnostic laparohysteroscopy.

Methods: HSG, Diagnostic Hysteroscopy and Laparoscopy were performed on a group of 50 Patient of primary and secondary infertility. Findings of HSG, Hysteroscopy and Laparoscopy were computed, analyzed and corelated.

Results: HSG showed a false positive rate of 25% for tubal factor and false negative 12% for uterine factors when compared with hysteroscopic and laparoscopic findings. The sensitivity of HSG was 75% and specificity was 88 % when compared with Hysteroscopic and Laparoscopic findings. Among various abnormality detected during the present study were, congenital anomaly 7(14%), Asherman syndrome 5 (10%), Tubal factor defect 6(12%), fibroid 3(6%) and Pelvi-inflammatory disease in 7(14%) of cases.

Conclusions: Though HSG is a simple procedure for detecting abnormality of female genital tract, due to its low specificity and sensitivity hysterolaparoscopy should be complemented during infertility work up in all patient.


Keywords


HSG, Hysteroscopy, Laparoscopy

Full Text:

PDF

References


White MJ, Muhidin S, Andrzejewaki C, Tagoe E, Knight R, Reed H. Urbanization and Fertility: An Event-History Analysis of Coastal Ghana. Demography. 2008;45(4):803-16.

Sarkar S, Gupta P. Socio-Demographic Correlates of Women’s Infertility and Treatment Seeking Behavior in India. J Reprod Infertil. 2016;17(2):123-32.

Kamel RM. Management of the infertile couple: an evidence-based protocol. Reprod Biol Endocrinology : RB&E. 2010;8:21.

Phillips CH, Benson CB, Ginsburg ES, Frates MC. Comparison of uterine and tubal pathology identified by transvaginal sonography, hysterosalpingography, and hysteroscopy in female patients with infertility. Fertil Res Pract. 2015 Dec 23;1:20.

Comparative Prospective Study of Hysterosalpingography and Hysteroscopy in Infertile Women Leena Wadhwa, Pooja Rani, Pushpa Bhatia J Hum Reprod Sci. 2017 Apr-Jun;10(2):73-8.

Maheux-Lacroix S, Boutin A, Moore L, Bergeron ME, Bujold E, Laberge P, Lemyre M, Dodin S. Hysterosalpingosonography for diagnosing tubal occlusion in subfertile women: a systematic review with meta-analysis. Hum Reprod. 2014 May;29(5):953-63.

Ngowa JDK, Kasia JM, Georges Ng-T, Nkongo V, Sone C, Fongang E. Comparison of hysterosalpingograms with laparoscopy in the diagnostic of tubal factor of female infertility at the Yaoundé General Hospital, Cameroon. Pan Afr Med J. 2015;22:264.

Otubu JA, Sagay AS, Dauda S. Hysterosalpingogram, laparoscopy and hysteroscopy in the assessment of the infertile Nigerian female. East Afr Med J. 1990 May;67(5):370-2.

Snowden EU, Jarrett JC 2nd, Dawood MY. Comparison of diagnostic accuracy of laparoscopy, hysteroscopy, and hysterosalpingography in evaluation of female infertility. Fertil Steril. 1984 May;41(5):709-13.

Makino T, Hara T, Oka C, Toyoshima K, Sugi T, Iwasaki K, Umeuchi M, Iizuka R. Survey of 1120 Japanese women with a history of recurrent spontaneous abortions. Eur J Obstet Gynecol Reprod Biol. 1992 Apr 21;44(2):123-30.

Maheux-Lacroix S, Boutin A, Moore L, Bergeron ME, Bujold E, Laberge P, Lemyre M, Dodin S. Hysterosalpingosonography for diagnosing tubal occlusion in subfertile women: a systematic review with meta-analysis. Hum Reprod. 2014 May;29(5):953-63.

Nigam A, Saxena P, Mishra A. Comparison of Hysterosalpingography and Combined Laparohysteroscopy for the Evaluation of Primary Infertility. KUMJ. 2015 Oct-Dec;13(52):281-5.

Vaid K, Mehra S, Verma M, Jain S, Sharma A, Bhaskaran S. Pan Endoscopic Approach “Hysterolaparoscopy” as an Initial Procedure in Selected Infertile Women. JCDR. 2014;8(2):95-98.