Pregnancy rate following normal versus abnormal hysterosalpingography findings: a meta-analysis.
A computerized Medline search was conducted, to assess the prognostic value of hysterosalpingography (HSG) and the probability of pregnancy after normal versus abnormal HSG findings. A total of 13 studies turned out to be eligible, reporting on 3,277 women. 15% of women with an abnormal HSG and 32% of women with a normal HSG achieved pregnancy. Sensitivities and specificities of the studies were heterogeneous. The pooled odds ratio was 3 (95% CI: 2.3-3.4). Its ROC Curve shows that, at the operating point yielding the lowest number of misclassifications, a sensitivity of 63% and a specificity of 62% is achieved. Seven studies reported unilateral and bilateral obstruction. Odds ratios were 2(95% CI: 1.5-2.6) and 19(95% CI: 7.5-46.5) respectively. So, overall, HSG has a low prognostic value, the outcome of HSG adds little to predicting the occurrence of pregnancy. However, when HSG shows bilateral obstruction, the chance of getting pregnant is only minimal.
Maas
J W
JW
Department of Obstetrics and Gynaecology, Academisch Ziekenhuis Maastricht, The Netherlands.
Evers
J L
JL
ter Riet
G
G
Kessels
A G
AG
D005184:Fallopian Tube Diseases / Q000150:complications*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D016239:MEDLINE; D011247:Pregnancy; D011379:Prognosis; D012372:ROC Curve