Predictive value of impaired uterine transport function assessed by negative hysterosalpingoscintigraphy (HSSG).
BACKGROUND
Hysterosalpingoscintigraphy (HSSG) has given insight into the dynamics of rapid sperm transport inside the female genital tract.


RESULTS
While there is an increase of an ipsilateral transport on the side bearing the dominant follicle in 70% of the subjects in the periovulatory phase, 15% of the patients do not demonstrate transport to the fallopian tubes (negative HSSG). In these patients the pregnancy rate achieved spontaneously or by intrauterine insemination is significantly reduced compared to the patients who showed an intact transport mechanism confirmed by positive HSSG. On the other hand, by means of assisted reproductive techniques (ART), pregnancy rates were higher in the group of patients showing negative HSSG (P < 0.0005).


CONCLUSIONS
Our data clearly indicate that HSSG is a helpful method to evaluate the integrity of the utero-tubal transport mechanism. As pregnancy rates remain low in patients with negative HSSG, this result should be considered as an indication for IVF-treatment even in patients with patent fallopian tubes and normozoospermia of the partner.
Kissler
S
S
Department of Gynaecology and Obstetrics, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen-Nuremberg, Germany. stefan.kissler@kgu.de
Wildt
L
L
Schmiedehausen
K
K
Kohl
J
J
Mueller
A
A
Rody
A
A
Ahr
A
A
Kuwert
T
T
Kaufmann
M
M
Siebzehnruebl
E
E
D005186:Fallopian Tube Patency Tests / Q000379:methods*; D005187:Fallopian Tubes / Q000000981:diagnostic imaging*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000175:diagnosis / Q000628:therapy; D011247:Pregnancy; D011877:Radionuclide Imaging; D020554:Sperm Injections, Intracytoplasmic; D013083:Sperm Transport; D013667:Technetium
D013667:Technetium