Publication:

Role of sonosalpingogram in correlation to hysterosalpingogram in assessment of infertility

Background This study was performed to evaluate the patency of fallopian tubes with hysterosalpingographyand sonosalpingographyin females with complaint of infertility and to correlate the results of sonosalpingogram with that of hysterosalpingogram in assessment of tubal patency in infertility.

Methods Females with complaint of infertility were evaluated by HSG (Hysterosalpingography) and SSG (Sonosalpingography) between 7th and 12th day of menstrual cycle. HSG was carried out using Siemens fluoroscopy machine. The flow of contrast was followed and tubal patency was assessed. SSG was carried out using Siemens ACUSON X300, with transvaginal probe (4-9MHz). Normal saline was infused slowly and the endometrial cavity was evaluated. Then color flow was used to evaluate each of the adnexa for free spillage of saline (waterfall sign) and results of both the techniques were correlated.

Results Altogether 94 tubes were evaluated by HSG & SSG each. On HSG, out of 94, 65 tubes were patent and 29 tubes showed blockage. On SSG, 68 tubes were patent and 26 tubes showed blockage. Results of both the techniques were correlated by Kappa value which came out to be 0.923. There was very good agreement between SSG and HSG.

Conclusions There was 92.3% agreement (KAPPA value = 0.923, Standard error = 0.437, 0.95 CI = 0.8373-1) between SSG and HSG which suggests that SSG is at least similar to HSG in its effectiveness for evaluating tubal patency and has the potential to replace HSG as routine, first-line outpatient infertility investigation.