Is hysterosalpingography an important tool in predicting fertility outcome?
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Published on: July 25, 2017
B W Mol1, P Swart, P M Bossuyt
1Academic Medical Center, University of Amsterdam, The Netherlands. B.W.MOL@AMC.UVA.NL
Objective:
To determine the prognostic significance of hysterosalpingography (HSG) for fertility outcome.
Design:
Retrospective cohort study.
Setting:
Infertility department of an academic hospital.
Patient(S):
Consecutive patients undergoing HSG for subfertility between May 1985 and November 1987.
Intervention(S):
Hysterosalpingography.
Main Outcome Measure(S):
Follow-up ended when pregnancy or tubal surgery occurred or at the day of last contact. Kaplan-Meier curves for the occurrence of spontaneous intrauterine pregnancy (IUP) were constructed for a normal HSG, a HSG with a one-sided abnormality, and a HSG with a two-sided abnormality. Fecundity rate ratios were calculated to express the association between HSG findings and the occurrence of spontaneous IUP.
Result(S):
Of 359 patients that were analyzed, 231 (64%) showed no tubal pathology on HSG, 67 (19%) had a one-sided tubal pathology, and 61 (17%) had a two-sided tubal pathology. The adjusted fecundity rate ratios were 0.81 (95% confidence interval 0.47 to 1.4) for a one-sided pathology and 0.30 (95% confidence interval 0.13 to 0.71) for a two-sided pathology. Correction for informative censoring and sensitivity analysis did not alter these results.
Conclusion(S):
One-sided tubal pathology detected on HSG has limited prognostic significance, whereas two-sided tubal pathology detected on HSG reduces fertility prospects considerably.
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