Comparison between hysterosalpingography and laparoscopic chromopertubation for the assessment of tubal patency in infertile women

Abstract

Background: Infertility is a critical component of reproductive health, and has often been neglected in these efforts. The inability to have children affects men and women across the globe. Infertility can lead to distress and depression, as well as discrimination and ostracism. Hysterosalpingography (HSG) of infertile women is useful for the assessment of structure of uterine cavity, tubes and their patency. However, although a more invasive procedure such as laparoscopy (L/S) which is regarded as the most reliable method in detection of tubal pathologies in infertility.Methods: This was a Prospective cross sectional study of 50 patients with history of primary or secondary infertility selected from IPD of Jawaharlal Nehru medical College and Acharya Vinobha Bhave Rural Hospital, Tertiary Health Care Centre Located in Sawangi, Wardha, Maharashtra (India). The age group of the patients was between 18 yrs. - 45 yrs. The study population was selected depending upon the total number of patients (fitting the criteria) visiting the IPD of AVBRH Department of Obstetrics and gynecology for a period of 1 years (September 2015 to September 2016). The collected data was compiled and proper statistical formulas were applied to analyze the data collected.Results: The present study include 50 cases of both primary and secondary infertility of which 29 cases (58%) were primary infertility and 21 cases (42%) were secondary infertility. In this study the 3(6%) cases were found in the age group of <20 years followed by 16 (32%) cases in the age group of 21-25 years, 19(38%) cases were in the age group of 26-30 years while 7(14%) cases were in the age group of 31-35years the age group of 36-40 years 2(14%) and in age group > 40 years is 3(6%). In the present study, based on Kuppuswamy index most (30%) of the women had class IV socio economic status in both primary and secondary infertility. In the present study, there were 6 (28.57%) cases with History of LSCS, 7 cases (33.33%) had FTND, 6(28.57%) cases had history of abortion, and 2(9.52%) had previous ectopic pregnancy. Moderate degree of agreement was found between findings of both tests.Conclusions: The results suggest that hysterosalpingography is useful as a primary screening procedure, but laparoscopy provides a more accurate assessment of tubal patency in the investigation of infertility.

Diagnostic accuracy of hysterosalpingography in comparison to laparoscopy to detect tubal occlusion in female infertility: An observational study

“…Our findings were very close to the reported study of Choudhary A at al. 5 The sensitivity, specificity, positive predictive value and negative predictive value were 80.85%, 74%, 49.35% and 92.5% respectably in the study to detect tubal occlusion by hysterosalpingography. The compared findings were significant (i.e.…”

“…In the last decade, increasing trend of infertility 2,3 was seen in global population, 4 almost 10-15% couple 4,5 needed infertility related advice. Increased trends of infertility mostly due to delayed marriage with delayed child bearing, increased prevalence of sexually transmitted disease and preponderance of pelvic endometriosis.…”

“…2,6 Hysterosalpingography (HSG) was used as a screening test to detect infertility from tubal occlusion. 5 The test is noninvasive, economical and less expertise is needed but with the risk of exposure of patients to radiation and iodinated contrast medium. It is an outpatient department procedure; 7 patients are less relaxed as sedation or anesthesia is not used during the procedure.…”