The validity of air and saline hysterosalpingo-contrast sonography in tubal patency investigation before insemination treatment.
OBJECTIVE
To compare the prognostic significance of tubal patency investigation by means of laparoscopy, hysterosalpingo-contrast sonography (HyCoSy) with air and saline as a contrast medium, and hysterosalpingography (HSG) in relation to the outcome of intrauterine insemination (IUI) treatment.


METHODS
A retrospective study of 559 consecutive women attending the university hospital infertility clinic for infertility treatment in 1996-2003. Tubal patency was evaluated by laparoscopy in 261 women, by HyCoSy in 217 and by HSG in 81 women before insemination treatment. Altogether, 1240 insemination cycles were evaluated and the results were compared in the three study groups.


RESULTS
The clinical pregnancy rates per cycle were 14%, 18% and 18% in the laparoscopic, HyCoSy and HSG groups, with no statistically significant difference between the groups. The cumulative pregnancy rates (mean 2.3 cycles) were 30%, 41% and 38%, respectively, with a significant difference between the study groups. In cases of unilateral patency, cumulative pregnancy rates after two cycles were 18% (laparoscopy), 29% (HyCoSy) and 29% (HSG). The numbers of tubal pregnancies were similar in the subgroups.


CONCLUSIONS
Hysterosalpingo-contrast sonography with air and saline as a contrast medium is a very cost-effective tubal investigation method as regards selection of subjects for insemination.
Ahinko-Hakamaa
Katja
K
Department of Obstetrics and Gynecology, Tampere University Hospital, PL 2000, 33521 Tampere, Finland. katja.ahinko-hakamaa@pshp.fi
Huhtala
Heini
H
Tinkanen
Helena
H
D000328:Adult; D000388:Air; D003287:Contrast Media; D005186:Fallopian Tube Patency Tests / Q000379:methods; D005187:Fallopian Tubes; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000379:methods; D007315:Insemination, Artificial / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D012965:Sodium Chloride
D003287:Contrast Media; D012965:Sodium Chloride