HYSTEROSONOSALPINGOGRAPHY AS A PRIMARY SCREENING PROCEDURE FOR ASSESSMENT OF TUBAL FACTOR OF INFERTILITY

Abstract

Abstract: Objective: To compare the efficacy of HSSG with HSG and to see whether HSSG can be used as a primary screening procedure for assessment of tubal factor in infertile patients. Methods: A comparative study was conducted on 64 patients presenting with complaint of infertility in Department of Obstetrics & Gynaecology, Acharya Shri Chander College of Medical Sciences, Jammu from June 2011 to June 2012. HSSG findings were compared with HSG findings. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of HSSG were calculated. Results: In our study, 81.25% cases were in the age group between 20-30 years. Sixty-nine percent of cases had primary infertility and 28% had secondary infertility of 2-10 years. HSSG had a sensitivity of 33% and specificity of 100% for uterine malformations as compared to HSG. In detecting tubal pathology, HSSG was found to have an overall sensitivity of 90%, specificity of 84.2%, PPV 93%, NPV 80% and concordance of 89% as compared to HSG. Also HSSG agreed with HSG findings in 91% for tubal patency and in 84.2% for tubal occlusion whereas disagreement was found in 9% of cases for tubal patency and 15% of cases for tubal block. Conclusion: HSSG can be used as primary procedure in detecting tubal factors in infertile patients. It has high sensitivity and specificity in detecting tubal patency. Also it allows concomitant visualization of ovaries and myometrium