Hysterosalpingography in the workup of female infertility: indications, technique and diagnostic findings
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Authors
Schankath, Adrian C.
Fasching, Nikola
Urech-Ruh, Cornelia
Hohl, Michael K.
Kubik-Huchcorresponding, Rahel A.
Issue Date
2012-07-17
Type
Article
Language
en_US
Keywords
Female Infertility , Hysterosalpingography , Fallopian Tubes
Alternative Title
Abstract
Objectives:
To evaluate the spectrum of diagnostic findings in hysterosalpingography (HSG) examinations performed at our institution between 2006–2010 and their prognostic significance for treatment decisions and fertility outcomes.
Methods:
Patients were filtered from our PACS. Pathological HSG studies were re-evaluated. Indications for referral, technical success and diagnostic findings were analysed. Pathological findings were correlated with further diagnostic workups, treatments and fertility outcomes.
Results:
Of 411 HSG examinations, 226 (55 %) were normal, 94 (23 %) showed minor abnormalities and 5 (1.2 %) were not diagnostic. Eighty-six (21 %) examinations were pathological. Twenty-nine patients underwent subsequent laparoscopy, during which proximal tubal occlusion diagnosed at HSG was ruled out in 9/23 cases. Follow-up information was unavailable for 20 patients. Nineteen of 66 patients with follow-ups after pathological HSG had at least one subsequent successful pregnancy. Forty-one patients had no further treatment and no pregnancies.
Conclusions:
The detection rate for pathologies at HSG was low (21 %). There was a high false-positive rate (39 %) for proximal tubal occlusion, most likely because of spasms, demonstrating the importance of delayed imaging after injection of antiperistaltic agents. HSG remains a valuable diagnostic tool. Our results, however, indicate that this technique should be more selectively indicated.
Description
Citation
Schankath, A. C., Fasching, N., Urech-Ruh, C., Hohl, M. K., & Kubik-Huch, R. A. (2012). Hysterosalpingography in the workup of female infertility: indications, technique and diagnostic findings. Insights into imaging, 3(5), 475–483. https://doi.org/10.1007/s13244-012-0183-y
Publisher
Insights into Imaging