Abstract
Purpose: Our goal was to assess, with a prospective study, the role of hysterosalpingo-contrast sonography (HyCoSy) with an echocontrast agent and transvaginal ultrasonography alone in the evaluation of tubal status.
Methods: Thirty patients were included in the study. These patients underwent an initial plain transvaginal ultrasound examination the day before the HyCoSy. The findings obtained from both examinations were compared with laparoscopic diagnosis, performed in the same menstrual cycle.
Results: The kappa values were 0.48 for patency evaluation and 0.67 for the diagnosis of the presence of at least one patent tube, suggesting a good agreement in both cases between HyCoSy and surgery. HyCoSy had a significantly lower sensitivity (50%), but not a significantly higher specificity (75%), than transvaginal ultrasonography alone in the diagnosis of tubal infertility-related abnormalities such as peritubal adhesions.
Conclusions: The study demonstrates that the HyCoSy is a useful test when scheduling the most suitable treatment for infertile couples.
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References
Seibel M: Infertility: A Comprehensive Text. Norwalk, CT: Appleton and Lange, 1990
Yablonski M, Sarge T, Wilde RA: Subtle variations in tubal anatomy in infertile women. Fertil Steril 1990;54:455–458
Fakih H, Marshall J: Subtle tubal abnormalities adversely affect gamete intrafallopian transfer outcome in women with endometriosis. Fertil Steril 1994;62:799–801
Melis GB, Paoletti AM, Strigini F, Menchini Fabris F, Canale D, Fioretti P: Pharmacologic induction of multiple follicular development improves the success rate of artificial insemination with husband's semen in couples with male-related or unexplained infertility. Fertil Steril 1987;47:441–445
Dodson WC, Whiteside DB, Hughes CL, Easley HA, Haney AF: Superovulation with intrauterine insemination in the treatment of infertility: A possible alternative to gamete intrafallopian transfer and in vitro fertilisation. Fertil Steril 1987;48:441–445
Melis GB, Paoletti AM, Ajossa S, Guerriero S, Depau GF, Mais V: Ovulation induction with gonadotropins as sole treatment in infertile couples with open tubes: A randomized prospective comparison between intrauterine insemination and timed vaginal intercourse. Fertil Steril 1995;64:1088–1093
Taylor PJ, Collins JA. Unexplained Infertility, 1st ed. Oxford, Oxford University Press, 1993
Deichert U, Schlief R, Van de Sandt M, Daume E: Transvaginal hysterosalpingo-contrast sonography for the assessment of tubal patency with gray scale imaging and additional use of pulsed wave Doppler. Fertil Steril 1992;57:62–67
American Fertility Society: Classification of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, Mullerian anomalies and intrauterine adhesions. Fertil Steril 1988;49:944–955
Armitage P, Berry G: Statistical Methods in Medical Research. 3rd rev ed. Oxford, Blackwell, 1994
Guerriero S, Mais V, Ajossa S, Paoletti AM, Risalvato A, Melis GB: The screening of embryonic viability in early asymptomatic pregnancy by a single endosonographic scan associated with plasma human chorionic gonadotropin determination. J Assist Reprod Genet 1994;11:346–352
Opsahl MS, Miller B, Klein TA: The predictive value of hysterosalpinography for tubal and peritoneal infertility factor. Fertil Steril 1993;60:444–448
Patten RM, Vincent LM, Wolner-Hanssen P Jr, Thorpe E: Pelvic inflammatory disease: Endovaginal sonography with laparoscopic correlation. J Ultrasound Med 1990;9:681–689
Lande IM, Hill M, Cosco FE, Kator NN: Adnexal and cul-desac abnormalities: transvaginal sonography. Radiology 1988;166:325–332
Glantz SA. Primer of Biostatistics, 1st ed. New York, McGraw-Hill, 1981
Bonilla-Musoles F, Simon C, Serra V, Sampaio M, Pellicer A: An assessment of hysterosalpingo-sonography (HSSG) as a diagnostic tool for uterine cavity defects and tubal patency. J Clin Ultrasound 1992;20:175–178
Stern J, Peters AJ, Coulam CB: Color Doppler ultrasonography assessment of tubal patency: A comparison study with traditional techniques. Fertil Steril 1992;58:897–900
Yarali H, Gurgan T, Erden A, Kisnisci HA: Colour Doppler hysterosalpingosonography: A simple and potentially useful method to evaluate fallopian tubal patency. Hum Reprod 1994;9:64–66
Deichert U, Schlief R, Van de Sandt M, Juhnke I: Transvaginal hysterosalpingo-contrast-sonography (Hy-Co-Sy) compared with conventional tubal diagnostics. Hum Reprod 1989;4:418–424
Schlief R, Deichert U: Hysterosalpingo-contrast sonography of the uterus and fallopian tubes: Results of a cinical trial of a new contrast medium in 120 patients. Radiology 1991;178:213–215
Balen FG, Allen CM, Siddle NC, Lees WR: Ultrasound contrast hysterosalpingography-evaluation as an outpatient procedure. Br J Radiology 1993;66:592–599
Campbell S, Bourne TH, Tan SL, Collins WP: Hysterosalpingo Contrast Sonography (HyCoSy) and its future role with in the investigation of infertility in Europe. Ultrasound Obstet Gynecol 1994;4:245–253
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Guerriero, S., Ajossa, S., Mais, V. et al. The screening of tubal abnormalities in the infertile couple. J Assist Reprod Genet 13, 407–412 (1996). https://doi.org/10.1007/BF02066173
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DOI: https://doi.org/10.1007/BF02066173