Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Comparison of hysterosonography and hysterosalpangiography in the diagnosis of intrauterine abnormalities in infertile women

Authors
Mahtab Zeinalzadeh 1
Tahereh Nazari 1
Mehrangiz Baleggi 2
1 Department of Obstet . and Gynecol Fateme Zahra Infertility Center, Shahid Yahyanejad Hospital, Babol University of Medical Science, Babol, Iran
2 Babol University of Medical Sciences, Babol, Iran
Abstract
Uterine abnormalities are found in approximately 34-62% of infertile women. Because of this relatively high prevalence of uterine abnormalities, evaluation of uterine cavity is performed in the primary evaluation of infertility. The purpose of this study was to compare the diagnostic accuracy of hysterosonography with that of hysterosalpangiography for the evaluation of abnormalities of uterine cavity of infertile women. Sixty six infertile women were prospectively evaluated with hysterosalpangiogram (HSG) and hysterosonogram (H/S) as a part of their infertility workup. The result of each examination was compared with what was obtained by hysteroscopy as a golden standard. The results of H/S agreed with hysteroscopy in 95.5% (K=0.86) while HSG agreed with hysteroscopy in 87.9% (K=0.64) of cases. Sensitivity of H/S was 85.7% and its specificity 98.1%, while sensitivity of HSG was 71.4% and its specificity 92.3%. Hysterosonography was in general more accurate test and appeared to be an acceptable first-line evaluation for intrauterine structure. We recommend use of hysterosonography as a noninvasive, easy, inexpensive, effective and well-tolerated method of investigating the intrauterine cavity in infertile women instead of hysterosalpangiography.
Keywords
Hysterosalpangiography
hysterosonography
Hystroscopy
Infertility
Intrauterine abnormally
  1. Wallah E.E. The uterine factor in infertility. Fertil Steril. 1972;23:138-58.
  2. Lindeman H., Mohr J. Co2 hysteroscopy diagnosis and treatment. Am J Obs Gyn. 1976;124:129-33.
  3. Ryan K.J., Berkowitz R.S., Barbieri R.L. Kistner’s gynecology principals and practice. 7th Edition,Philadelphia, WB Sunders. 1999;PP741-805.
  4. Donnez J., Nisolle M. An atlas of operative laparoscopy and hysteroscopy. 2th Edition, New York, The Pathenon publishing group. 2001; PP395-7.
  5. Speroff L., Galass R.H. Clinical gynecologic endocrinology and infertility. 6th Edition, Philadelphia,Lippincott Williams. 1999;PP321-79.
  6. Hamilton J.A., Larson A.J., Lower A.M. Routine use of saline hesterosonography in 500 consecutive, unselected, infertilities women. Hum Reprod. 1998;13(9):2463-73.
  7. Soares S.R., Camargos A.F. Diagnostic accuracy of by sonohysterography, trans-vaginal sonography and hysterosalpangiography in patients with uterine cavity diseases. Fertil Steril. 2000;73(2):406-11.
  8. Brawn S.E., Coddington C.C., Schnorr J. Evaluation of outpatient hysteroscopy, salin infusion hysterosonography, hysterosalpangiography in infertile women: a prospective, randomized study. Fertil Steril. 2000;74(5):1029-34.
  9. Darwish A.M., Youssef A.A. Screening sonohysterography in infertility. Gyn Obs Invest. 1999;48(1):43-7.
  10. Hamilton B., Gaucherand P. Transvaginal sonohysterography evaluation of intrauterine adhesions. BMJ Reprod Med. 1998;31(1):101-4.
  11. Lee A., Ying Y.K., Novy M.J. Hysteroscopy, hysterosalpingography and tubal ostial polyps in infertility patients. J Reprod Med. 1997;42(6):337-41.
  12. Schwarzler P., Concin H., Bosch H., et al. An evaluation of sonohysterography and diagnostic hysteroscopy for assessment of intrauterine pathology. Ultrasound Obs Gyn. 1998;11:337-42.
  13. Van den Brule F.A., Wery O. Comparison of contrast hysterosonography and transvaginal ultrasonography for uterus imaging. J Gyn Obs Biol Reprod. 1999;28(2):131-6.
  14. Goldberg J.M., Falcon T., Attaran M. Sonohysterography to evaluate uterine defects on hysterosalpangiography and its correlation with hysteroscopy. J Am Assoc Gyn Laparoscopy. 1996;3(4 Suppl):S16.
  15. Lindheim S.R., Morales A.J. Comparison of sonohysterography and hysteroscopy: lessons learned and avoiding pitfalls. J Am Gyn Laparoscopy. 2002;9(2):223-31.
  16. Bacci P., Wanden B.J., Bernard J.P. Evaluation of transvaginal sonography with salin contrast. J Gyn Obs. 1997;11(2):121-4.
  17. Larson A.J., Lower A.M. Hysterosonography in infertile women. Hum Reprod. 1998;13(9):63-73.
  18. Dinaro E., Brata F. Diagnosis of benign uterine pathology by hesterosonography. Clin Exp Obs Gyn. 1997;23(2):103-7.
  19. Wang C.W., Lee C., Lai Y. Comparison of hysterosalpangiography and hysteroscopy in female infertility. J Am Assoc Gyn Laparoscopy. 1996;3(4):58-4.
  20. Rudigoz R., Sale B. Hysterosonographic study of the uterine cavity. J Gyn Obs Reprod Paris.1997;24(7):697-704.
  21. Ayida G., Chamberlain P., Barlow D. Uterine cavity assessment prior to in vitro fertilization: Comparison of transvaginal, saline contrast hysterosonography and hysteroscopy. Ultrasound Obs Gyn. 1997;10(1):59-62.
  22. Lindheim S.R., Sauer M. Upper genital tract screening with hysterosonography. Int J Gyn. 1999;60(1):47-50.
  23. Alatas C., Aksoy E., Akarsu C., et al. Evaluation of intrauterine abnormalies in infertile patients by sonohysterography. Hum Reprod. 1997;12(3):487-90.
Journal of Reproduction & Infertility
Volume 3, Issue 4
Autumn 2002
Pages 29-35