[A comparative study between hysterosalpingography and laparoscopy in evaluating female infertility]

Area of Science:

• Reproductive Medicine
• Diagnostic Imaging
• Minimally Invasive Surgery

Background:

• Infertility affects a significant portion of the reproductive-age population.
• Accurate diagnosis of tubal and peritoneal factors is crucial for effective infertility management.
• Hysterosalpingography (HSG) and laparoscopy are common diagnostic modalities, but their comparative accuracy requires clarification.

Purpose of the Study:

• To prospectively compare the diagnostic accuracy of hysterosalpingography (HSG) and laparoscopy in evaluating infertility.
• To determine the concordance and discordance rates between HSG and laparoscopy for assessing tubal patency and peritoneal factors.
• To identify specific conditions where one method outperforms the other in infertility diagnosis.

Main Methods:

• A prospective study involving 143 infertile women over two years.
• Hysterosalpingography performed with water-soluble contrast medium on days 7-10 of the menstrual cycle.
• Laparoscopic chromopertubation using methylene blue dye performed on days 8-16.

Main Results:

• Agreement between HSG and laparoscopy was observed in 66.4% of patients.
• HSG had a 10.4% false-negative rate and a 23% false-positive rate for tubal obstruction.
• Laparoscopy identified significant discrepancies, particularly in peritubal adhesions (58.7%), and revealed other conditions like endometriosis and PCOS.

Conclusions:

• Hysterosalpingography serves as a valuable primary screening procedure for infertility.
• Laparoscopy provides a more definitive assessment of tubal patency and peritoneal disease in infertile women.
• Laparoscopy is essential for a comprehensive evaluation when HSG results are inconclusive or discordant.