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Comparison of hysterosalpingography and hysteroscopy in female infertility
1Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, 5 Fu-Hsin Street, Kwei-Shan, Tao-Yuan, Taiwan, Republic of China.
Study Objective:
To determine the diagnostic value of hysterosalpingography (HSG) and diagnostic hysteroscopy in infertility evaluations.
Design:
Comparative 2-year study.
Setting:
Outpatient infertility clinic of a tertiary medical center.
Patients:
Two hundred sixteen women being investigated for infertility.
Interventions:
An HSG was followed by a diagnostic hysteroscopy.
Measurements And Main Results:
The HSGs were interpreted as normal in 79 (36.9%) women and as showing some abnormalities of the uterine cavity in 135 (63.1%). In the former group, 51 patients had a normal uterine cavity, but 28 had abnormal findings on hysteroscopy, a false negative rate of 35.4%. Of 135 women with an abnormal HSG, hysteroscopy found a normal uterine cavity in 21, a false positive rate of 15.6%. The sensitivity of HSG was 80.3% in revealing intrauterine abnormality and its specificity was 70.1%. Although some abnormalities were identified by both methods in 114 women, findings of both procedures were similar in only 88 (77.2%). In 75 (35.0%), the findings of HSG differed from those of hysteroscopy. In only 139 (65%) patients were the findings (normal and abnormal) similar for both methods.
Conclusions:
We advocate hysteroscopy in the investigation of female infertility for its accuracy, safety, simplicity, and convenience.