Can ultrasound-based investigations replace laparoscopy and hysteroscopy in infertility?
OBJECTIVE
To compare the use a simplified ultrasound based infertility investigation of the infertile couple with the current use of laparoscopy and hysteroscopy.


METHODS
Thirty-three infertile couples underwent transvaginal ultrasound and hystero-salpingo-contrast-sonography. A diagnosis was formulated based on the results of the ultrasound investigations, a semen analysis and endocrine parameters. The following day, all subjects underwent a laparoscopic chromotubation and hysteroscopy by a surgeon unaware of the ultrasound findings. A diagnosis based on the findings at laparoscopy and hysteroscopy, the same semen analysis and endocrine parameters, was then made. The two diagnoses were compared.


RESULTS
A 90.9% agreement was found between the diagnoses made from the two methods used. When considering laparoscopic diagnosis the Gold Standard of tubal patency, the sensitivity to diagnose occluded tubes using hystero-contrast-sonography was 92.8%. The corresponding figures for specificity, PPV and NPV were 96.2%, 92.8% and 98.1%, respectively.


CONCLUSIONS
A simple, ultrasound based approach to investigate the infertile couple, can be used effectively as an initial examination modality during the couple's work-up. However, there is a need for a larger study to confirm these results.
Hauge
K
K
Department of Obstetrics and Gynecology, RITO University Hospital, Tromsö, Norway.
Flo
K
K
Riedhart
M
M
Granberg
S
S
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D005500:Follow-Up Studies; D006801:Humans; D007047:Hysterosalpingography / Q000379:methods*; D015907:Hysteroscopy / Q000379:methods*; D007247:Infertility, Female / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000628:therapy; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D014463:Ultrasonography / Q000379:methods