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A novel use of vaginoscopic office hysteroscopy for prediction of tubal patency and peristalsis among infertile women: a preliminary study

  • Original Article
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Gynecological Surgery

Abstract

The objective of this study is to test whether vaginoscopic office hysteroscopy (OH) can predict proximal tubal patency as compared with hysterosalpingography (HSG) and diagnostic laparoscopy (DL) and concomitantly tubal peristalsis in infertile women. This is a prospective cross sectional study. The setting is in the endoscopy unit of a tertiary hospital. A total of 85 infertile patients scheduled for laparoscopy are used as the sample of this study. The method used is the vaginoscopic OH in the outpatient infertility clinic to assess proximal tubal patency. The patency results will be compared to HSG and DL reports. Diagnostic accuracy of OH alone or in combination with HSG for assessment of proximal tubal patency in comparison to HSG and DL is the mean outcome measure. Office hysteroscopic bubble suction test was feasible in 78 cases (91.7 %). Patent tubes were diagnosed in 91 and 88.5, 92.3 and 91, and 93.6 and 93.6 % using OH, HSG, and DL on right and left sides, respectively. The percentage of agreement between OH and DL was 78 % while it was 84 % between HSG and DL regarding tubal patency testing. Diagnostic indices of OH were very close to those of HSG. Adding OH to HSG did not improve diagnostic accuracy. Positive osteal peristalsis was reported in 32 cases (42 %) and 28 cases (36.8 %) for right and left ostea, respectively. Hysteroscopic bubble suction test is a good initial screening test for tubal patency nearly comparable to HSG and DL. It should be attempted in every case of OH prior to referral for more invasive HSG or laparoscopic chromopertubation test. Hysteroscopic documentation of peristalsis of the proximal part of the tube is an interesting cofinding but requires more confirmatory studies.

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Abbreviations

OH:

Vaginoscopic office hysteroscopy

HSG:

Hysterosalpingography

DL:

Diagnostic laparoscopy

TVS:

Transvaginal ultrasonography

ASRM:

The American Society of Reproductive Medicine

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Woman’s Health University Hospital, Assiut University, Assiut, 71111, Egypt

    Atef M. Darwish, Ahmad I. Hassanin, Mahmoud A. Abdel Aleem, Islam H. Aboushama & Ibraheem I. Mohammad

Authors
  1. Atef M. Darwish
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  2. Ahmad I. Hassanin
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  3. Mahmoud A. Abdel Aleem
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  4. Islam H. Aboushama
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  5. Ibraheem I. Mohammad
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Corresponding author

Correspondence to Atef M. Darwish.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 and its later amendments or comparable ethical standards.

Funding

This study was not funded.

Conflict of interest

The authors declare that they have no competing interests.

Informed consent

All procedures were followed and informed consent was obtained from all patients for being included in the study.

Additional information

Key message:

As a quick initial screening test for tubal patency in infertile cases, every hysteroscopist should pay attention to tubal suction of air bubbles during office hysteroscopy.

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Darwish, A.M., Hassanin, A.I., Aleem, M.A.A. et al. A novel use of vaginoscopic office hysteroscopy for prediction of tubal patency and peristalsis among infertile women: a preliminary study. Gynecol Surg 13, 187–192 (2016). https://doi.org/10.1007/s10397-016-0944-6

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  • DOI: https://doi.org/10.1007/s10397-016-0944-6

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