ABSTRACT
Introduction: Infertility is a leading psychosocial problem in couples. Diagnostic evaluation of uterine tube is important in the management of infertility. Causes or factors of female infertility can basically be classified regarding whether they are acquired or genetic, age, smoking, sexually transmitted infections (STIs), adhesions in the peritoneal cavity, previous abdomen surgeries, diabetes mellitus, smoking, alcohol, celiac disease, liver and kidney disease and being overweight or underweight can all affect fertility. Proper evaluation of the infertility is needed for better management of the cases of infertility. Aim of the study: To assess the efficacy of Sonosalpingography (SSG) and Hysterosalpingography (HSG) in the diagnosis and management of infertility. Materials and methods: A total 75 cases attending the department with complaint of infertility. Cases between ages 21 years and 44 years were recruited for this study. Duration of this study was two years, from June 2016 to May 2018. All the cases were undergone with baseline transabdominal sonogram, real time transvaginal sonography and saline infusion sonography to examine pelvic region of the cases. All the participants had to undergo SSG on 8th day and HSG on 10th day of the menstrualcycle. Data was collected and sensitivity and specificity of SSG over HSG was assessed. Statistical analysis was done by using SPSS software version 14.0. Results: Diagnosis by SSG showed bilateral tubal patency in 83.93% cases and by HSG showed bilateral tubal patency in 75% cases. SSG and HSG both correlated well (95.3%) and both procedures had similar diagnostic accuracy. In this study, positive predictive value was 95.2% and negative predictive value was 94.6%. Sensitivity was 98.3%, specificity 85.6% and accuracy rate of this study was 95.8%. The outcome of this study indicates that there is no statistically significant difference (p=0.338) between the values of SSG and HSG. Conclusion: SSG is cost effective and radiation free procedure. The outcome of SSG is almost similar to the values of HSG.
ABSTRACT
Background: Infertility is a global issue in reproductive health. In many cultures the ability to have children is important sign of an individual's worth. Aim and objective: To compare hysterosalpingography, transvaginal sonosalpingography and laparoscopic chromotubation for evaluation of tubal factor in infertility. Materials and methods: This consisted of 50 infertile women with either primary or secondary infertility. Including investigations for other factors, tubal factor was evaluated by hysterosalpingography, transvaginal sonosalpingography and laparoscopic chromotubation (in one or two cycles). Results: The results of 50 cases of Infertility for Tubal patency by sonosalpingography, HSG, laparoscopy. 36 cases were of primary infertility and 14 cases of secondary infertility. Mean duration of primary and secondary infertility were 5.79 ± 3.19 and 5.97 ± 3.36 years respectively. Maximum number of cases had duration of infertility between 1 to 4 years (45.2 %). The average age in subjects of primary infertility were 26.25 ± 3.85 years and in subjects of secondary infertility were 29.73 ± 4.87 years. Up to 70% of cases had a high school or less than high school education and 92% of women were not employed. 29 patients had bilateral patency, in 14 patients had bilateral block, In 7 patients had unilateral block (either proximal or distal. findings in sonosalpingography, bilateral patency in 34 cases, findings at laparoscopy, bilateral patency number of cases 32 (64%), bilateral block no. of cases 12 (24%) and unilateral block no. of cases 6 (12%). In the group of Patients with Bilateral Patency there were 2 false Negative for HSG i.e. 22%, HSG and Laparoscopy are in agreement with 94%. There were 2 false positives for TVS i.e. 22%, between TVS and Laparoscopy J. Anuradha, K. Aruna Kumari, A. Sujatha. Comparative study of tubal patency by hysterosalpingography, transvaginal sonosalpingography and laparoscopy. IAIM, 2016; 3(9): 126-133. Page 127 were in agreement with 94%. In the group of patients with bilateral block there was 100% agreement between TVS and Laparoscopy. There was 2 false positive for bilateral block, agreement between HSG and Laparoscopy being only 94%. In the group of patients with unilateral block there were 2 false negatives for TVS rate 22%, agreement between TVS and Laparoscopy being 67%, For HSG false positive rate 11%, agreement between HSG and Laparoscopy being 85.5%. Conclusion: Low risk subjects for tubal factors in infertility, sonosalpingography can be employed as a screening procedure to pick up subjects needing HSG and laparoscopy. It is simple, in expensive, minimally invasive and one which would be complimentary to the armamentorium of infertility investigations already available.