AUTHOR=Tan Jifan , Deng Min , Xia Meng , Lai Muhua , Pan Wenwei , Li Yubin 

TITLE=Comparison of Hysterosalpingography With Laparoscopy in the Diagnosis of Tubal Factor of Female Infertility

JOURNAL=Frontiers in Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.720401

DOI=10.3389/fmed.2021.720401

ISSN=2296-858X

ABSTRACT=Background: Laparoscopy is considered to be the gold standard in the evaluation of causes leading to infertility. Hysterosalpingography (HSG) permits indirect visualization of the cervical canal, the uterine cavity, and the patency of the tube, which was helpful for the evaluation of the cause of infertility.
Objective: To detect tubal abnormality in infertile women by HSG or laparoscopy and determine the value of HSG in diagnosing fallopian tube status.
Methods: 1276 patients were included in this study. HSG was performed as a preliminary test for the evaluation of fallopian tube status. Women were subjected to laparoscopic examination on evidence of HSG abnormalities.
Results: The negative predictive value of HSG for detecting patency or occlusion for the right/left tube was 92.08% and 95.44%, respectively. The kappa value for the consistent diagnosis in the right/ left tube was 0.470 and 0.574, respectively. In cases of not-so-patency of right/left tube, there was more than 40% chance for the tube to be patency, and the remaining high probability was pelvic adhesion. The positive predictive value of HSG for detecting patency or occlusion for both tubes was 87.2%. The kappa value was 0.898 (95%CI (0.838, 0.937), p<0.001), which meant that the diagnostic accuracy of HSG for both tube patency/occlusion was explicit. The kappa value for the diagnosis of hydrosalpinx (especially for bilateral tube hydrosalpinx) was 0.838 (95%CI (0.754, 0.922), p<0.001), and the diagnostic accuracy for HSG was 79.8%, 67.9%, and 72.4%, respectively. 
Conclusion: HSG was a good diagnostic modality to detect tube abnormalities in infertile patients. HSG and laparoscopy are complementary to each other and whenever the patient is undertaken for diagnosis of infertility. A cost-effective HSG had good predictive value in identifying tubal factor infertility.