Abstract

Background: Sonohysterosalpingography (SonoHSG) is a new method for assessing tubal patency using transvaginal ultrasound. It is having several advantages over conventional hysterosalpingography (HSG). The present study prospectively evaluated the performance of SonoHSG and HSG in establishing tubal patency or blockage. 

Materials and Methods: This prospective observational study was carried out to assess the value of sonohysterosalpingography (SonoHG) in evaluating tubal patency in infertile patients and to compare its results with hysterosalpingography (HSG) and laparoscopic chromotubation. This study included 54 infertile women. All women underwent both SonoHSG and HSG. Patients in whom tubal block had been established by either SonoHSG or HSG underwent laparoscopic chromotubation. Each tube was evaluated individually.

Results: With laparoscopic findings as the gold standard, sonohysterosalpingography had a sensitivity of 100%, specificity of 85.7%, positive predictive value of 87.5% and a negative predictive value of 100%. The rate of agreement with laparoscopy was 87.5%. The findings for the same parameters using HSG were 100%, 75%, 80%, and 100%, respectively. The rate of laparoscopic agreement with HSG was 8%. Sonohysterosalpingography showed more uterine abnormalities than HSG.

Conclusion: Sonohysterosalpingography using agitated saline is a low-cost, reliable, safe examination method. It can be used for the primary investigation of infertility on an outpatient basis.  When performed by experienced operators, it serves as a valuable, first-line screening test for more invasive procedures like laparoscopic chromotubation.