Hysterosalpingography versus laparoscopy in tubal infertility: comparison based on findings at laparatomy

One hundred ten infertile women underwent hysterography (HSG) and laparoscopy at the Obafemi Awolowo University, Nigeria. Both techniques showed normal tubal patency in 62 (56.4%) women and abnormal pelvic pathology in 48 (43.6%). All 48 women underwent laparotomy for tuboplasty. At laparotomy, HSG and laparoscopic assessments were compared. Both techniques were comparable in the diagnosis of intratubal and distal tubal occlusion. However, laparoscopy was superior in the diagnosis of non-tubal factors and proximal tubal occlusion (P less than 0.002). It is suggested that laparoscopy should be the first procedure in the investigation of tubal infertility and only followed by HSG if the results show some abnormality.