A feasibility study to evaluate pelvic peritoneal anatomy with a saline intraperitoneal sonogram (SIPS)

Area of Science:

• Reproductive Medicine
• Diagnostic Imaging
• Gynecologic Surgery

Background:

• Unexplained infertility affects numerous women, necessitating accurate diagnostic tools.
• Hysterosalpingography (HSG) is a standard but limited method for evaluating pelvic anatomy.
• Adhesive disease and hydrosalpinx are potential causes of infertility that require precise detection.

Purpose of the Study:

• To establish the safety and feasibility of a novel imaging technique, saline intraperitoneal sonogram (SIPS).
• To assess SIPS's efficacy in evaluating pelvic anatomy in women with unexplained infertility and normal HSG results.

Main Methods:

• A prospective clinical case series involving ten women with unexplained infertility.
• The procedure involved sonohysterography followed by ultrasound-guided saline infusion into the peritoneal cavity.
• Pelvic anatomy was visualized using 3D and 4D pelvic ultrasound.

Main Results:

• All ten patients completed the SIPS protocol successfully.
• SIPS identified unilateral hydrosalpinx and filmy adhesive disease in one patient with no prior risk factors.
• Significant adhesive disease was detected by SIPS in three of five patients with known risk factors, confirmed laparoscopically.
• The average procedure time was 45 minutes.

Conclusions:

• Saline intraperitoneal sonogram (SIPS) is a safe, rapid, and potentially cost-effective outpatient method.
• SIPS demonstrates utility in diagnosing pelvic adhesive disease and other abnormalities in women with unexplained infertility.
• This technique offers a valuable alternative for pelvic anatomy evaluation when HSG is normal.