Hysterosalpingography: an appraisal of current indications

A prospective study was carried out on 230 consecutive hysterosalpingograms (HSGs), in which a variety of techniques was used. The primary site of investigation was tubal, uterine and cervical in 76.5, 7.8 and 15.7% of cases respectively. The highest incidence of abnormal findings was obtained in the investigation of secondary infertility, especially following tubal surgery. Twenty-five women had a laparoscopy and dye insufflation within nine months of their HSG, and fully concordant results were found in 17 cases. The disposable cervical cup method of hysterosalpingography offered a precise means of quantifying the internal cervical os diameter. The mean internal os diameter in those women referred with a past history of mid-trimester abortion was significantly greater than that of the group with secondary infertility (P less than .05). A diameter of 0.7 cm is suggested as a practical cut-off point for the radiological diagnosis of cervical incompetence.