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

The diagnostic accuracy of hysterosalpingography and laparoscopy was compared. One hundred fourty three infertile women were prospectively investigated in two years duration. Laparoscopic chromopertubation using methylen blue dye performed on days 8-16. Hysterosalpingography performed on days 7-10 with water soluble contrast medium. There was agreement between the results of both methods in 66.4 per cent /95/ of the patients. In 15 of the 63 patients with a normal hysterosalpingography, however, peritubal or tubal disease was observed at the time of laparoscopy/false-negative results, 10.4%/Eighty patients with tubal obstructions were detected by hysterosalpingography, but 33 obstructions were not confirmed by laparoscopy/false-positive results, 23%/. The greatest discrepancy between the hysterosalpingography and laparoscopy was found in peritubal adhesions--58.7%. Laparoscopic evaluation demonstrated also endometriosis in 41 cases, poly cystic ovaries in 12, ovarian cyst in 9, and uterine fibroids in 15. Intrauterine abnormalities were diagnosed by hysterosalpingography in only 2.9% per cent of the patients. No significant laparoscopic complications were noted. The results suggest that hysterosalpingography is useful as a primary screening procedure, but laparoscopy provides a more accurate assessment of tubal patency and peritoneal factors in the investigation of infertility.