A STUDY ON THE ROLE OF CONTRAST HYSTEROSALPINGOGRAPHY AS A TEST FOR TUBAL PATENCY IN THE ASSESSMENT OF INFERTILITY

Aim and Objectives: To assess the value of Hysterosalpingography in evaluating the uterine abnormalities and tubal patency in infertile patients and to compare its results with established methods like hysterosalpingography for determination of tubal patency in cases of primary and secondary infertility. Methods: In this study , trial of 50 women complaining of infertility ,suspected tubal pathologies underwent various radiological modalities. Hysterosalpingography was performed in all cases. Result: The results of 50 cases of Infertility for Tubal patency by HSG 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.finds 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 Negatives for HSG ie, 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: Several modalities have been suggested for the diagnosis of suspected Tubal patency ,however Sonosalpingography the initial most useful technique to confirm or exclude tubal patency .