Can hysterosalpingocontrast-sonography replace hysterosalpingography in the assessment of tubal subfertility?
BACKGROUND
Hysterosalpingo-contrastsonography (HyCoSy) is a new method for assessing tubal patency using transvaginal ultrasound. It is thought to have several advantages over conventional hysterosalpingography (HSG). We prospectively evaluated the performance of HyCoSy and HSG in the diagnosis of tubal pathology.


METHODS
One-hundred consecutive subfertile women underwent both HyCoSy and HSG in randomised order. Results of both tests were related to findings at laparoscopy with dye, which was used as the reference test. Each woman was asked to score the pain exsperienced at both procedures on a visual analogue scale.


RESULTS
When laparoscopy with dye was used as reference test, the likelihood ratios of HyCoSy were slightly inferior to those obtained for HSG. Since the performance of HyCoSy was dependent on experience, the results were recalculated omitting the 50 initial procedures from the analysis. In that calculation, results of HyCoSy and HSG were comparable. There were no differences in pain experienced during the procedure, as there appeared also to be no differences in patient preferences.


CONCLUSIONS
There appear to be no strong arguments either to replace HSG by HyCoSy, or to reject the use of HyCoSy. Both procedures can be used in the evaluation of tubal pathology.
Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Room H4-205, Academic Medical Centre, University of Amsterdam, PO Box 22700, 1100 DE, Amsterdam, Netherlands.
A B
AB
Dijkman
B W
BW
Mol
F
F
van der Veen
P M
PM
Bossuyt
H V
HV
Hogerzeil
D000328:Adult; D005069:Evaluation Studies as Topic; D005184:Fallopian Tube Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005187:Fallopian Tubes / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000379:methods*; D007247:Infertility, Female / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010535:Laparoscopy; D011446:Prospective Studies; D011897:Random Allocation; D014463:Ultrasonography