Hyterosalpingoscintigraphic [HSS] evaluation of fallopian tubes patency and physiology in normal and patients with unexplained infertility

ABSTRACT

In this work, 135 female patients with unexplained infertility as well as 45 age-matched controls were subjected to radionuclide HSS between day 9-16 of their menstrual cycles aiming to examine ovarian regulation on functional Fallopian tube patency in normal females, quantification of radiotracer Fallopian tubal transit time [TTT] in both normal and females with unexplained infertility and evaluation of functional Fallopian tube obstruction as a possible cause of unexplained infertility. HSS was done using 10 MBq 99 mTc- MAA of 5-40 um in diameter placed on posterior vaginal fornix. Serial anterior pelvic gamma camera images were obtained at five-minute intervals up to one hour and every 0.5 hour up to 4 hours. Delayed 24 hours images were taken if required. The results were related to the sonographically determined dominant follicle. Dominant follicle sided functional tubal patency was observed in 97% of normal with mean TTT 10 +/- 4 minutes as well as 40% of patients with their mean TTT 110 +/- 10 minutes. Functional Fallopian tube obstruction was observed in 60% of patients with unexplained infertility. The results indicated that HSS is a simple, noninvasive, sensitive and valuable method for evaluation of Fallopian tube patency and physiology in patients with unexplained infertility