DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20196070

Comparative study of hysteroscopy, hysterosalpingography and transvaginal sonography in evaluation of the female infertility

Shivangani Vohra, Mamta Tyagi, Smriti Gupta, Esha Khanuja

Abstract


Background: One of the most important and underappreciated reproductive health problems in developing countries is that of infertility. Objective of this study was to evaluate HSC (hysteroscopy), HSG (hysterosalpingography) and ultrasonography in infertility.

Methods: This study was conducted among 100 infertile patients over a period of two years. The patients were questioned for the detailed history including socioeconomic status, medical history and previous history of taking any medications and supplements. The recruited patients had to undergo.

Results: Transvaginal sonography and clinical examination were done. Transvaginal sonography detected abnormality in 40% of women. 65 women had normal hysterosalpingography findings whereas the rest 35 women had abnormal hysterosalpingography findings. Thirty nine percent (39%) had normal hysteroscopic findings while sixty one percent (61%) had abnormal findings. The study depicts that hysteroscopy has sensitivity (95%) and negative predictive value NPV (92%) whereas that of TVS is 48.9% and 44.9% respectively. Hysterosalpingography has sensitivity 68.3% and NPV 40.3%. Specificity (100%) and positive predictive value PPV (100%) of all the three modalities are the same.

Conclusions: The results of the present study showed that each modality provided useful information but no single modality provided complete information for evaluating infertile women. Thus, a combination of all three modalities- TVS (transvaginal sonography), HSG (hysterosalpingography) and hysteroscopy is necessary to evaluate infertile women.


Keywords


Hysterosalpingography, Hysteroscopy, Infertility, Transvaginal sonography

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References


American Society for Reproductive Medicine. Assisted reproductive technologies: a guide for patients, 2015. Available at: http://www.reproductivefacts.org/globalassets/rf/news-and-publications/bookletsfact-sheets/english-fact-sheetsand-info-booklets/art.pdf. Accessed on 28th March, 2019.

International Institute of population Sciences. National Family Health Survey; 1998-99, India. International Institute of population Sciences, Mumbai, India. 2000. Available at: https://dhsprogram.com/pubs/pdf/FRIND2/FRIND2.pdf. Accessed on 22th June 2019.

Talwar PP, Go OP, Murali IN. Prevalence of infertility in different population groups in India and its determinants. In: Statistics and Demography. New Delhi: National Institute of Health and Family Welfare and Indian Council of Medical Research; 1986. Available at: https://In:+Statistics+ and+demography&author=PP+Talwar&author=OP+Go&author=IN+Murali&publication_year=1986. Accessed on 28th June 2019.

Dutta S, Guha R. A clinico-anatomical study on the etiological factors pertaining to primary infertility in females using some common investigative procedures. J Anat Soc India. 2007;56:14-7.

Shukla P, Yadav K, Mishra S. Hysteroscopic evaluation of uterine cavity in cases of infertility and its correlation with transvaginal ultrasound and hysterosalpingography. Int J Reprod Contracept Obstet Gynecol. 2016;5:3843-8.

Kamel RM. Management of the infertile couple: an evidence-based protocol. Reprod Biol Endocrinol. 2010;8:21.

Phillips CH, Benson CB, Ginsburg ES, Frates MC. Comparison of uterine and tubal pathology identified by transvaginal sonography, hysterosalpingography, and hysteroscopy in female patients with infertility. Fertility Res Pract. 2015;1(1):20.

Niknejadi M, Haghighi H, Ahmadi F, Niknejad F, Chehrazi M, Vosough A, et al. Diagnostic accuracy of transvaginal sonography in the detection of uterine abnormalities in infertile women. Iranian J Radiol. 2012;9(3):139.

Benkaddour Y, Gervaise A, Fernandez H. Which is the method of choice for evaluating uterine cavity in infertility workup? J Gynecol Obstet Biol Reprod (Paris). 2010;39(8):606-13.

El-Mazny A, Abou-Salem N, El-Sherbiny W. Outpatient hysteroscopy: a routine investigation before assisted reproductive techniques? Fertil Steril. 2011;95(1):272-6.

Koskas M, Mergui J, Yazbeck C, Uzan S, Nizard J. Office hysteroscopy for infertility: a series of 557 cases consecutives. Obstet Gynecol Int. 2010;16:80-96.