Comparison of Hysterosalpingography with Laparoscopy and Chromopertubation

We compared two methods of determining tubal patency. Between January 1, 1993, and December 31, 1994, 55 women were evaluated for infertility by laparoscopy and chromopertubation and either traditional hysterosalpingogram (HSG; group 1, 25 patients, 16 primary, 9 secondary infertility) or a mixture of Hy-Co-Sy with Echovist (group 2, 30 patients, 14 primary, 16 infertility). In group 1 HSG showed 64% bilateral patency, 8% unilateral patency, and 28% bilateral occlusion; laparoscopy and chromopertubation showed 72%, 8%, and 20%, respectively. Identical findings were present in 92% of women, with method sensitivity and specificity of 100% and 89.4%, respectively. One case of allergic reaction occurred. In group 2, rates with Hy-Co-Sy and Echovist were 63.3% bilateral patency, 23.3% unilateral, and 13.3% bilateral occlusion; laparoscopy and chromopertubation results were 83.3%, 10%, and 6.7%, respectively. Identical findings were present in 86.7% of patients, with method sensitivity and specificity of 100% and 84.9%, respectively. No side effects were noted. The high sensitivity of both methods suggest that either one is of value in primary assessment of tubal patency, as neither requires general anesthesia and both may precede laparoscopy of hysteroscopy.