Is hysterosalpingography an important tool in predicting fertility outcome?
OBJECTIVE
To determine the prognostic significance of hysterosalpingography (HSG) for fertility outcome.


METHODS
Retrospective cohort study.


METHODS
Infertility department of an academic hospital.


METHODS
Consecutive patients undergoing HSG for subfertility between May 1985 and November 1987.


METHODS
Hysterosalpingography.


METHODS
Follow-up ended when pregnancy or tubal surgery occurred or at the day of last contact. Kaplan-Meier curves for the occurrence of spontaneous intrauterine pregnancy (IUP) were constructed for a normal HSG, a HSG with a one-sided abnormality, and a HSG with a two-sided abnormality. Fecundity rate ratios were calculated to express the association between HSG findings and the occurrence of spontaneous IUP.


RESULTS
Of 359 patients that were analyzed, 231 (64%) showed no tubal pathology on HSG, 67 (19%) had a one-sided tubal pathology, and 61 (17%) had a two-sided tubal pathology. The adjusted fecundity rate ratios were 0.81 (95% confidence interval 0.47 to 1.4) for a one-sided pathology and 0.30 (95% confidence interval 0.13 to 0.71) for a two-sided pathology. Correction for informative censoring and sensitivity analysis did not alter these results.


CONCLUSIONS
One-sided tubal pathology detected on HSG has limited prognostic significance, whereas two-sided tubal pathology detected on HSG reduces fertility prospects considerably.
Mol
B W
BW
Academic Medical Center, University of Amsterdam, The Netherlands. B.W.MOL@AMC.UVA.NL
Swart
P
P
Bossuyt
P M
PM
van der Veen
F
F
D000328:Adult; D000704:Analysis of Variance; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005836:Genitalia, Female / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000000981:diagnostic imaging* / Q000473:pathology; D015993:Life Tables; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors