Original Research

Uterine and tubal anatomical abnormalities in infertile women: diagnosis with routine hysterosalpingography prior to selective laparoscopy

Mwaffaq Heis, Zouhair Amarin, Alaa Ibrahim, Nael Obeidat, Basil Obeidat, MA'MOON AL-Omari
South African Journal of Radiology | Vol 15, No 4 | a354 | DOI: https://doi.org/10.4102/sajr.v15i4.354 | © 2011 Mwaffaq Heis, Zouhair Amarin, Alaa Ibrahim, Nael Obeidat, Basil Obeidat, MA'MOON AL-Omari | This work is licensed under CC Attribution 4.0
Submitted: 24 February 2011 | Published: 07 December 2011

About the author(s)

Mwaffaq Heis,
Zouhair Amarin,
Alaa Ibrahim,
Nael Obeidat,
Basil Obeidat,, Jordan
MA'MOON AL-Omari,


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Abstract

Objective: To assess the findings and usefulness of hysterosalpingography as a routine investigation in the fertility workup prior to selective laparoscopy.

Design: Descriptive retrospective study.

Setting: A university hospital in the north of Jordan.

Subjects: All hysterosalpingographies performed in the period between 1st January and 31 December 2008.

Outcome measures: Detection of uterine and fallopian tube abnormalities and their correlation with laparoscopic findings.

Results: During the study period, 281 infertile women underwent hysterosalpingography with no post procedural complications. The mean (SD) age was 31.5 (5.91) years. Mean (SD) duration of infertility was 4 (3.44) years. Infertility was reported as primary and secondary by 119 (42.3 %) and 162 (57.6 %), respectively. Altogether 281 patients and 562 tubes were examined. Of those, 402 were patent and 160 occluded. There was only one woman in whom peritubal adhesions were diagnosed. Because of hysterosalpingographically diagnosed tubal occlusion, 46 women (16.4 %) were referred for laparoscopy. Eight (17.3%) of them were treated with unilateral salpingectomy and 28 (60.8%) with bilateral salpingectomy. Salpingolysis was performed for 7 (15.2%) women, and 3 (6.7%) women had untreatable adhesions. The concordance was 71.7%. The sensitivity of HSG was 80%, the specificity 50%, the negative predictive value 61% and the positive predictive value 71%. Of the total of 281 women, 30 (10.7%) conceived within 1 - 11 months after the hysterosalpingography.

Conclusions: The very high abnormal predictive value of hysterosalpingography in the diagnosis of tubal occlusion suggests that this procedure could be performed as a screening examination.

Keywords

Hysterosalpingography, Infertility

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