Hysterosalpingography Vs Hysteroscopy in the Detection of Intrauterine Pathology in Infertility

Shakya, B

doi:10.3126/jnhrc.v7i1.2271

Cited by 5 publications

(7 citation statements)

References 13 publications

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“…9 In our study, 13% of the patients had abnormal HSG regarding the uterine cavity and 20% of the patients had abnormal hysteroscopic findings, though the difference was not statistically significant (chi-square value: 1.77, p value > 0.05). A similar trend was found in the study by Shakya et al 10 where he detected only 2% abnormal cases on HSG and 12% abnormal cases on HSC. In contrast to this, Ganglione et al 11 in their study had 47.1% patients with pathological findings on HSG and 41.4% patients had pathological findings on HSC.…”

Section: Discussionsupporting

confidence: 86%

Hysterosalpingography vs Hysteroscopy: Role in Assessment of Uterine Factor during Infertility Workup

Nanda¹,

Malhotra²,

Malik³

et al. 2013

Journal of South Asian Federation of Obstetrics and Gynaecology

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Objective: Uterine pathologies are the cause of infertility in 15% of infertile couples and their correction is associated with improved pregnancy rates. This prospective study was carried out to compare hysterosalpingography (HSG) with hysteroscopy (HSC) in evaluation of uterine pathology. Study design:The research was approved by the institutional review board. A total of 100 infertile women were included in the study. HSC and HSG were performed in the follicular phase and the findings were compared. Student's t-test and chi-square test were applied wherever applicable. Degree of agreement between the two procedures was calculated using kappa estimates.Results: Thirteen percent of the women had abnormal HSG regarding the uterine cavity while 20% had abnormal HSC findings (chi-square value 1.77, p > 0.05). Sensitivity of HSG in detecting uterine cavity abnormality was 50% and specificity 98.1%. Positive predictive value was 76.9% and negative predictive value was 88.5%. Result of HSG was false negative in 10% of women and false positive in 3%. In 77% of patients, both HSG and HSC were normal and in 10% of patients, both were abnormal. The degree of agreement between HSG and HSC as calculated by kappa estimates was 0.545. Conclusion:Hysteroscopy should be considered essential while investigating infertile women. Since HSG provides valuable information about tubes, it may supplement the hysteroscopic assessment.

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Section: Discussionsupporting

confidence: 86%

Hysterosalpingography vs Hysteroscopy: Role in Assessment of Uterine Factor during Infertility Workup

Nanda¹,

Malhotra²,

Malik³

et al. 2013

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…A combination of HSG and MR imaging can provide a road map for fibroid locations and to guide fertility-restoring therapy [16]. Interestingly, HSG has high PPV (98.2%) in diagnosing abnormal uterine contour in our study, similarly [12].…”

Section: Discussionsupporting

confidence: 51%

“…Nigam et al [11] reported a 70% PPV with 12.96% false negative rate. Shakya B [12] reported a 90% accuracy with 83.3% false negative rate, and false positive rate close to zero. These conflicting results may be related to the variable sample size and prevalence of each pathology.…”

Section: Discussionmentioning

confidence: 92%

“…In the current study, the overall sensitivity and specificity of HSG in diagnosing uterine cavity abnormalities were 90.8% and 96.5%, respectively. Wide ranges of sensitivity (21% to 81%) and specificity (70% to 98%) have been reported in the literature [10][11][12][13][14][15] Taskin et al [10] attributed their low sensitivity to the predominant malefactor of infertility in the couples visiting their clinic. Nigam et al [11] reported a 70% PPV with 12.96% false negative rate.…”

Section: Discussionmentioning

confidence: 99%

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The validity of HSG in infertility work up

Ahmed

Abo-Taleb

2019

Egypt J Radiol Nucl Med

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Background: Our purpose was to evaluate the diagnostic accuracy of hysterosalpingography (HSG) in the diagnosis of the uterine cavity and tuboperitoneal abnormalities in infertile women. Reproducibility and consistency were also assessed. Two hundred infertile females underwent HSG, hysteroscopy, and/or laparoscopy as part of infertility workup. HSG examinations were retrospectively reviewed by three radiologists; we compared interobserver variability, and differences between the two results of reading the same examination after 3 months were compared to calculate intraobserver variability. HSG sensitivity, specificity, PPV, NPV, and accuracy were calculated. Results: The overall accuracy of HSG in diagnosing tubal, uterine cavity, and peritoneal abnormalities was 95.5%, 95%, and 89%, respectively (P value < 0.04). HSG is reproducible in diagnosing normal versus abnormal examinations. Reproducibility in diagnosing uterine cavity, tubal, and peritoneal abnormalities was (ICC = 0.90), (ICC = 0.70), and (ICC = 0.31), respectively. Best agreement was seen in diagnosing luminal filling defect (sub mucous fibroid/polyp) (ICC = 0.90) (95% CI 0.86-0.98), whereas poorest agreement was found in diagnosing uterine adhesions (ICC = 0.13) (95% CI 0.10-0.13) and pelvic adhesions (ICC = 0.12) (95% CI 0.10-0.13) (P value < 0.03). HSG consistency ranged from moderate to good (K = 0.49-0.79). It was highest in diagnosing normal versus abnormal examination (P value < 0.01); poorest in diagnosing pelvic adhesions. Conclusion: HSG has high validity in negative results; it can minimize the use of invasive procedures. Laparoscopy is recommended in patients who had a pelvic disease or showing tubal obstruction on HSG.

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“…In study by Nigam et al .,[ 10 ] the positive predictive value of HSG for detecting the intrauterine abnormalities was 70% with a false-negative rate of 12.96%. Shakya,[ 11 ] in his study on investigating the accuracy of HSG in comparison to hysteroscopy in the detection of intrauterine pathology in infertility, found that HSG in the detection of intrauterine pathology had a sensitivity of 16.7%, specificity 100%, PPV 100%, NPV 89.8%, false-positive rate close to zero, false-negative rate 83.3%, and accuracy rate 90%. This difference in results from the present study could be because both HSG and hysteroscopy were done in same menstrual cycles and sample size was also less.…”

Section: Discussionmentioning

confidence: 99%

Comparative prospective study of Hysterosalpingography and hysteroscopy in infertile women

2017

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Aim:To compare the findings and diagnostic accuracy of Hysterosalpingography (HSG) and hysteroscopy in infertile women.Setting and Design:Prospective comparative study in a tertiary care Centre.Material and Methods:108 women with primary or secondary infertility were recruited. In all women after basic infertility workup, both HSG and hysteroscopy were performed.Results:Out of 108 women, in 3 women HSG couldn’t be done and in one woman there was uterine perforation on hysteroscopy. HSG showed normal uterine cavity in 77.8% (81/105) women and abnormal in 22.85% (24/105). Hysteroscopy findings were normal in 70.09% (75/107) and abnormal in 29.91% (32/107). Hysteroscopy detected incidental findings in 15.38% (16/104) cases. HSG showed irregular uterine cavity in 14.15% (15/105) women but on hysteroscopy; normal cavity was present in 6 (40%) women and abnormality was detected in 9 (60%) women. The sensitivity, specificity, positive predictive and negative predictive value of HSG in evaluating uterine cavity abnormalities were 44.83% (95% confidence interval (CI); 0.26–0.64), 86.67% (95% CI; 0.76–0.93), 56.52% (95% CI; 0.34–0.76) and 80.25% (95%CI; 0.69–0.88). Positive likelihood ratio and negative likelihood ratio of HSG in detecting uterine cavity abnormality was 3.36 and 0.64 respectively. The agreement between HSG and hysteroscopy was 75%. This was statistically significant (P value = 0.001) with fair strength of agreement between HSG and hysteroscopy. (k value= 0.336).Conclusion:Hysteroscopy should be performed in all infertile patients as it can detect significant number of incidental findings missed by HSG.

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Hysterosalpingography Vs Hysteroscopy in the Detection of Intrauterine Pathology in Infertility

Cited by 5 publications

References 13 publications

Hysterosalpingography vs Hysteroscopy: Role in Assessment of Uterine Factor during Infertility Workup

Hysterosalpingography vs Hysteroscopy: Role in Assessment of Uterine Factor during Infertility Workup

The validity of HSG in infertility work up

Comparative prospective study of Hysterosalpingography and hysteroscopy in infertile women

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