title: A simplified ultrasound based infertility investigation protocol and its implications for patient management.
abstract: OBJECTIVE
  To evaluate whether a simplified infertility investigation protocol, focusing on the use of hysterocontrast sonography (HyCoSy), one blood test, and a semen analysis, would be sufficient as an initial screening test to select couples for specific treatment.
  
  
  METHODS
  The infertile couples underwent gynaecological examination, cervical sampling for cytology and Chlamydia trachomatis culture, B-mode transvaginal ultrasonography and basic hormonal analyses followed by a HyCoSy, and a semen analysis. A preliminary diagnosis was made for all patients. A management plan for treatment was suggested when possible; otherwise further examinations were recommended. The data were stored for later analysis and the routine investigation protocol was then adhered to and a final diagnosis and treatment were decided upon.
  
  
  RESULTS
  Agreement between the diagnosis based on HyCoSy and our routine protocol was present in 74% of cases (N = 73). In 13% (N = 13) there was partial agreement. In 36% the HyCoSy based protocol was considered sufficient to suggest treatment.
  
  
  CONCLUSIONS
  A simplified approach may lead to a significant reduction in both the time and cost of investigating an infertile couple.
authors.affiliation: Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Strandell
authors.forename: T
authors.initials: T
authors.lastname: Bourne
authors.forename: C
authors.initials: C
authors.lastname: Bergh
authors.forename: S
authors.initials: S
authors.lastname: Granberg
authors.forename: J
authors.initials: J
authors.lastname: Thorburn
authors.forename: L
authors.initials: L
authors.lastname: Hamberger
mesh_terms: D005069:Evaluation Studies as Topic; D005260:Female; D006403:Hematologic Tests; D006801:Humans; D007246:Infertility / Q000000981:diagnostic imaging*; D008297:Male; D011247:Pregnancy; D012661:Semen / Q000166:cytology; D014463:Ultrasonography