Hysterosalpingography: value in estimating tubal function, and risk of infectious complications

A prospective study of 80 patients referred for hysterosalpingography (HSG). In 74 patients HSG was performed as part of an infertility investigation. Samples taken from the cervix were cultured for N. gonorrhoeae, Chl. trachomatis and M. hominis. Serum specimens were examined for antibodies against Chl. trachomatis and M. hominis. Two of our patients (2,5%) developed clinical signs of pelvic inflammatory disease following the procedure. Both had negative cultures for pathogenic microbes. The value of pre-HSG microbial culturing seemed negligible. Most patients had antibodies against Chl. trachomatis and M. hominis. Occlusion in one or both tubes was seen in 22 patients while possible pelvic adhesions were found in 15. It is concluded that HSG seems to have a relatively high risk of infectious complications, and we propose to do laparoscopy with chromopertubation as the primary step for evaluation of tubal function in infertile women.