Comparative study of tubal patency by hysterosalpingography, transvaginal sonosalpingography and laparoscopy

Background: Infertility is a global issue in reproductive health. In many cultures the ability to have children is important sign of an individual's worth. Aim and objective: To compare hysterosalpingography, transvaginal sonosalpingography and laparoscopic chromotubation for evaluation of tubal factor in infertility. Materials and methods: This consisted of 50 infertile women with either primary or secondary infertility. Including investigations for other factors, tubal factor was evaluated by hysterosalpingography, transvaginal sonosalpingography and laparoscopic chromotubation (in one or two cycles). Results: The results of 50 cases of Infertility for Tubal patency by sonosalpingography, HSG, laparoscopy. 36 cases were of primary infertility and 14 cases of secondary infertility. Mean duration of primary and secondary infertility were 5.79 ± 3.19 and 5.97 ± 3.36 years respectively. Maximum number of cases had duration of infertility between 1 to 4 years (45.2 %). The average age in subjects of primary infertility were 26.25 ± 3.85 years and in subjects of secondary infertility were 29.73 ± 4.87 years. Up to 70% of cases had a high school or less than high school education and 92% of women were not employed. 29 patients had bilateral patency, in 14 patients had bilateral block, In 7 patients had unilateral block (either proximal or distal. findings in sonosalpingography, bilateral patency in 34 cases, findings at laparoscopy, bilateral patency number of cases 32 (64%), bilateral block no. of cases 12 (24%) and unilateral block no. of cases 6 (12%). In the group of Patients with Bilateral Patency there were 2 false Negative for HSG i.e. 22%, HSG and Laparoscopy are in agreement with 94%. There were 2 false positives for TVS i.e. 22%, between TVS and Laparoscopy were in agreement with 94%. In the group of patients with bilateral block there was 100% agreement between TVS and Laparoscopy. There was 2 false positive for bilateral block, agreement between HSG and Laparoscopy being only 94%. In the group of patients with unilateral block there were 2 false negatives for TVS rate 22%, agreement between TVS and Laparoscopy being 67%, For HSG false positive rate 11%, agreement between HSG and Laparoscopy being 85.5%. Conclusion: Low risk subjects for tubal factors in infertility, sonosalpingography can be employed as a screening procedure to pick up subjects needing HSG and laparoscopy. It is simple, in expensive, minimally invasive and one which would be complimentary to the armamentorium of infertility investigations already available.