A study evaluation of tubal factors of infertility by hystero-salpingography and diagnostic laparoscopy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20200331Keywords:
Chromopertubation, Hysterosalpingography, Hysterolaparoscopy, InfertilityAbstract
Background: Infertility is one of the commonest problems encountered in gynecology. Infertility appears to be a problem in 10-15% of Indian population. Tubal factors account for (20-40%) of infertility. The objective of the study was to demonstrate the role of hystero-salpingography and hystero-laparoscopy in evaluation of tubal factors for female infertility.
Methods: Present study was carried out on 70 women attending the gynaecology OPD for investigation of infertility admitted between March 2014 to December 2014 in Gynecology ward, SSG Hospital attached to Government Medical College, Vadodara, Gujarat.
Results: Out of 70 patients who underwent HSG tubal block was detected in 34 cases. Out of these 34 cases tubal block was detected only in 17 cases by laparoscopy and chromopertubation. One case which showed patent tubes on HSG had unilateral tubal block on chromopertubation test. Accordingly, sensitivity of HSG for tubal patency comes out to be 0.72, specificity of 0.94, positive predictive value of 97.43%, negative predictive value of 51.61%, positive likelihood ratio of 12.28 and negative likelihood ratio of 0.30.
Conclusions: HSG being simple and less invasive technique along with higher specificity and lesser complications. Hystero-laparoscopy is a valuable technique for the complete assessment of female infertility.
References
Mira A, Mylene WMY, Fujii DT, Burney RO, Schust DJ. Berek and Novak’s Gynecology. 16th ed. Philadelphia. Wolters Kluwer. 2020:942-1000.
Padubidri VG, Daftary SN. Shaw’s textbook of gynecology. 13th Edn. Reed Elsevier India Pvt Ltd; 1988:237-262.
Seibel MM, diagnostic evaluation of infertile couple, Chapter 1, A comprehensive text of infertility, 2nd Edn. Appleton and Lange Publications; 1997.
Phelps JY. Diagnosis and contemporary management of infertility. Clin Obst Gynecol. 1998;18:1-7.
Lakhkar BN. Radiological procedures a guideline. 2nd edition, Arya publication Pvt Ltd; 2014:131-135.
Confino E, Radwanska E. Tubal factors in infertility. Curr Opin Obstet Gynecol. 1992;4(2):197-202.
Tsuji I, Ami K, Fujinami N, Hoshiai H. The significance of laparoscopy in determining the optimal management plan for infertile patients with suspected tubal pathology revealed by hysterosalpingography. Tohoku J Exp Med. 2012;227(2):105-8.
National Institute for Clinical Excellence, NHS. Fertility problems: assessment and treatment. Clinical guideline. Available at: http:// www. nice. org. uk/guidance/cg156. Accessed 15th August 2019.
Shetty SK, Shetty H, Rai S. Laparoscopic evaluation of tubal factor in cases of infertility. Int J Reprod Contracept Obstet Gynecol. 2013;2(3):410-3.
Sharma R, Sharma V. The infertile women; a study of 120 cases. J Indian Med Assoc. 1991;89(2):31-2.
Meenal A, Nalini A. A Laparoscopy in infertility. Int J Biol Med Res. 2014;5(1):3865-8.
Bello TO. Pattern of tubal pathology in infertile women in hysterosalpingographyin Ilorin, Nigeria. Annals African Med. 2004;3(2):77-9.
Swart P, Mol BW, Van D, Veen F, Beudn M, Redekop WK, Bossuyt PM. The accuracy of hysterosalpingography in the diagnosis of tubal pathology: a meta analysis. Fertil Steril. 1995;64:486-91.
