Changing the Algorithm in the Evaluation of Pelvic Anatomy in the Infertile Patient: Is Hysterosalpingo Contrast Sonography With Saline-Air Device the Appropriate Test for Everyone?
DOI:
https://doi.org/10.17140/GOROJ-2-126Abstract
The evaluation of the fallopian tubes is an essential part of the infertility workup, with abnormalities related to the fallopian tubes accounting for up to 40% of female subfertility. Laparoscopy is still considered the gold standard in the diagnostic evaluation of fallopian tubes, though the hysterosalpingogram (HSG) has long been recognized as complementary to laparoscopy, since tubal anatomy can be distinctly be seen.2 That said, previous investigations using laparoscopy as the gold standard demonstrate HSG has a sensitivity and specificity of 53% and 87%, respectively, for any tubal pathology and 46% and 95%, respectively, for bilateral tubal pathology.
References
Bradshaw KD, Carr BR. Modern diagnostic evaluation of the infertile couple. In: Carr BR, Blackwell RE, eds. Textbook of Re-productive Medicine. 2nd ed. East Norwalk, CT, USA: Appleton & Lange; 1998: 443-452.
Al-Badawi IA, Fluker MR, Bebbington MW. Diagnostic lapa-roscopy in infertile women with normal hysterosalpingograms. J Reprod Med. 1999; 44: 953-957.
Okonofua FE, Essen UI, Nimalaraj T. Hysterosalpingography versus laparoscopy in tubal infertility: comparison based on find-ings at laparotomy. Int J Gynaecol Obstet. 1989; 28: 143-147.
Musich JR, Behrman SJ. Infertility laparoscopy in perspec-tive: review of five hundred cases. Am J Obstet Gynecol. 1982; 143: 293-303.
Siegler AM. Hysterosalpingography. In: Wallach E, Zacur H, eds. Reproductive Medicine and Surgery. 1st ed. St Louis, MO, USA: Mosby-Year Book; 1995: 481-508.
Karande VC, Pratt DE, Balin MS, Levrant SG, Morris RS, Gleicher N. What is the radiation exposure to patients during a gynecoradiologic procedure? Fertil Steril. 1997; 67: 401-403. doi: 10.1016/S0015-0282(97)81931-0
Strandell A, Bourne T, Bergh C, Granberg S, Asztely M, Thorburn J. The assessment of endometrial pathology and tubal patency: a comparison between the use of ultrasonography and X-ray hysterosalpingography for the investigation of infertility patients. Ultrasound Obstet Gynecol. 1999; 14: 200-204. doi: 10.1046/j.1469-0705.1999.14030200.x
Darby SC, Wall BF. The genetically significant dose from di-agnostic radiology in Great Britain. Radiography.1981; 47: 200- 202.
Nannini R, Chelo E, Branconi F, Tantini C, Scarselli GF. Dy-namic echohyhsteroscopy: a new diagnostic technique in the study of female infertility. Acta Eur Fertil. 1981; 12: 165-171.
Richman TS, Viscomi GN, de Cherney A, Polan ML, Alcebo LO. Fallopian tubal patency assessed by ultrasound following fluid injection. Work in progress. Radiology. 1984; 152: 507- 510. doi: 10.1148/radiology.152.2.6539931
Mitri FF, Andronikou AD, Perpinyal S, Hofmeyr GJ, Son-nendecker EW. A clinical comparison of sonographic hydrotu-bation and hysterosalpingography. Br J Obstet Gynaecol. 1991; 98: 1031-1036. doi: 10.1111/j.1471-0528.1991.tb15342.x
Volpi E, Zuccaro G, Patriarca A, Rustichelli S, Sismondi P. Transvaginal sonographic tubal patency testing using air and saline solution as contrast media in a routine infertility clinic setting. Ultrasound Obstet Gynecol. 1996; 7: 43-48. doi: 10.1046/j.1469-0705.1996.07010043.x
Chenia F, Hofmeyr GJ, Moolla S, Oratis P. Sonographic hy-drotubation using agitated saline: A new technique for improv-ing fallopian tube visualization. Br J Radiol. 1997; 70: 833-836. doi: 10.1259/bjr.70.836.9486049
Jeanty P, Besnard S, Arnold A, Turner C, Crum P. Air-con-trast sonohysterography as a first step assessment of tubal paten-cy. J Ultrasound Med. 2000; 19: 519-527. Web site. http://www. jultrasoundmed.org/content/19/8/519.long. Accessed March 11, 2016.
Malik S, Always SM, Gustafson K, Sanfillippo JS. Evalua-Gynecol Obstet Res Open J tion of tubal patency with the femvueTM saline air device: are we ready to move back to the office. Fertil Steril. 2013; 100(3): S38. doi: 10.1016/j.fertnstert.2013.07.729
Singh M, Diamond MP, Awonuga A, Shavell V, Bolnick J, Puscheck EE. An office-based observational study of 10 female infertility evaluations performed using sono HSG with the Fem-Vue Saline-Air Device. Fertil Steril. 2013; 100(3): 100(3): S34. doi: 10.1016/j.fertnstert.2013.07.730
Exacoustos C, Zupi E, Carusotti C, Lanzi G, Marconi D, Arduini D. Hysterosalpingo-contrast sonography compared with hysterosalpingography and laparoscopicdye pertubation to evaluate tubal patency. J Am Assoc Gynecol Laparosc. 2003; 10: 367-372. doi: 10.1016/S1074-3804(05)60264-2
Deichert U, Schleif R, van de Sandt M, Juhnke I. Trans-vaginal hysterosalpingo-contrast-sonography (Hy-Co-Sy) com-pared with conventional tubal diagnostics. Hum Reprod. 1989; 4: 418-424. Web site. http://humrep.oxfordjournals.org/con-tent/4/4/418.short. Accessed March 11, 2016.
Hamed HO, Shahin AY, Elsamman AM. Hysterosalpingo-contrast sonography versus radiographic hysterosalpingograph-yin the evaluation of tubal patency. Int J Gynaecol Obstet. 2009; 105: 215-217. doi: 10.1016/j.ijgo.2009.02.001
Robertshaw IM, Sroga JM, Batcheller AE, et al. Hysterosal-pino-contrast sonography with a saline-air device is equivalent to hysterosalpingography only in the presence of tubal patency. J Ultrasound Med. 2016; 35: e1-e8.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Gynecology and Obstetrics Research (GOR) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.
