Correlation between hysterosalpingography and pelvic endoscopy for the evaluation of tubal factor

In this study of 132 infertile couples, findings with hysterosalpingography (HSG) were compared with those observed at subsequent culdoscopy or laparoscopy. Both procedures correctly revealed normal tubes in 29% of the subjects and identical abnormalities in 24%. A complete agreement between the two procedures was thus observed in 53% of women. Hysterosalpingography showed 5% false positive and 14% false negative findings. In the remaining cases the type of anomaly revealed by HSG was different from that found at laparoscopy. Peritubal adhesion was the pathologic process most commonly missed by HSG and diagnosed subsequently by endoscopy. Pelvic endoscopy also revealed endometriosis and other pelvic disease in a high proportion of women, whereas HSG exclusively detected all intrauterine lesions. Similar pregnancy rates resulted when HSG and endoscopy revealed normal organs. The significance of these findings is discussed.