Study on Comparative Diagnostic Efficacy of HSG & Laparoscopy in Infertility.

ABSTRACT

Tubal occlusion is one of the most frequent causes of infertility in women. The evaluation of the fallopian tube is necessary in female infertility. The two most important diagnostic procedures for evaluation of tubal patency are hysterosalpingography (HSG) and laparoscopy. We wanted to compare the diagnostic efficacy of HSG & diagnostic laparoscopy in evaluation of tubal patency in infertility.METHODSA hospital OPD based prospective study was conducted among fifty patients fulfilling the inclusion and exclusion criteria who attended the OPD for treatment of infertility in the Department of Obstetrics and Gynaecology, Medical College and Hospital, Kolkata from 1st January 2016 - 31st December 2017. After taking proper history, thorough examination and basic investigations for infertility work-up, HSG and Laparoscopy were performed.RESULTSAnalysis showed that most of the patients were in the age group of 30 to 35 years. Incidence of primary and secondary infertility was 64% and 36% respectively. Right proximal and distal blockage in HSG, and DL were 56% and 40% in HSG and 48% and 28% in DL respectively. p=0.0001. Left proximal and distal blockage in HSG and DL were 32% and 56 % in HSG and 40% and 28 % in DL. Right and left hydrosalpinx on HSG and DL were 32% and 12% in HSG and 40% and 16 % in DL. p<0.005. Right and left peri-tubal adhesions on HSG and DL were 36% and 20% at HSG and 52% and 28 % in DL. p<0.005. Thus, laparoscopy is superior in detection of hydrosalpinx and peritubal adhesions than HSG. In this analysis, the incidence of submucosal, intramural and subserous fibroids was 16%, 12% and 8 % respectively. Incidence of septate, unicornuate, bicornuate & arcuate uterus was 8%, 6%, 6%, 2% respectively. Intrauterine adhesions were detected in 12% and endometrial polyp in 4% of patients.CONCLUSIONSHSG is considered to have a high sensitivity and specificity to detect tubal block. HSG and laparoscopy are not alternative, but are complementary in the evaluation of tubal block.