A radiological approach to infertility--hysterosalpingography

The hysterosalpingograms of 98 patients with infertility were reviewed with reference to technical problems, radiological features of each pathology and accuracy of reporting. Findings were confirmed by review of the reports of laparotomy or laparoscopy on all patients. Of the total number of fallopian tubes investigated (196), 70 hydrosalpinges were correctly diagnosed from a total of 77. Agreement between HSG and operation was achieved in 123 of 127 fallopian tubes with peritubal adhesions, in all six of those with cornual spasm and in eight with cornual occlusion. In 16 of 20 fallopian tubes with partial distal occlusion, reporting was correct. With the potential accuracy of HSG diagnosis, we contend that it should be a preliminary procedure in every case, and in many may be the only investigation of tubal patency required prior to surgery or conservative management.