title: Comparison between transvaginal sonography after diagnostic hysteroscopy and laparoscopic chromopertubation for the assessment of tubal patency in infertile women.
abstract: OBJECTIVE
  Diagnostic hysteroscopy has become a well-established modality for evaluating the uterine cavity, but provides no information regarding tubal patency. The aim of the present study was to investigate the diagnostic value of transvaginal sonography (TVS), performed directly after diagnostic hysteroscopy, for assessing tubal patency in infertile women, and to compare the findings with those obtained by means of laparoscopic chromopertubation.
  
  
  METHODS
  A total of 56 infertile patients were referred to our endoscopic unit for laparoscopic chromopertubation in the period from September 2008 to January 2010. Diagnostic hysteroscopy, followed by TVS, was carried out prior to laparoscopic chromopertubation. The collection of free fluid in the pouch of Douglas was accepted as evidence of tubal patency. The findings of TVS and laparoscopic chromopertubation were compared. The data were analyzed for the sensitivity, specificity, accuracy, positive-predictivevalue, and negative-predictive value of the combination of hysteroscopy and TVS in detecting unilateral or bilateral tubal patency.
  
  
  RESULTS
  The presence of fluid in the pouch of Douglas was observed in 37 of the 56 cases. In 36 of these cases, unilateral or bilateral tubal patency was confirmed by laparoscopic chromopertubation. In 17 of the remaining 19 cases (without fluid in the pouch of Douglas during ultrasound), bilateral tubal occlusion was confirmed by laparoscopic chromopertubation. Diagnostic hysteroscopy followed by TVS showed a high sensitivity and specificity for the assessment of tubal patency.
  
  
  CONCLUSIONS
  TVS performed directly after diagnostic hysteroscopy in infertile patients provides additional nformation regarding tubal patency.
authors.affiliation: Obstetric and Gynecology University Hospital Queen Geraldine, Obstetric and Gynecology, Boulevard Zogu I, Tirana, Albania.
authors.forename: Julian
authors.initials: J
authors.lastname: Habibaj
authors.forename: Halim
authors.initials: H
authors.lastname: Kosova
authors.forename: Sokol
authors.initials: S
authors.lastname: Bilali
authors.forename: Valbona
authors.initials: V
authors.lastname: Bilali
authors.forename: Diana
authors.initials: D
authors.lastname: Qama
mesh_terms: D000328:Adult; D005186:Fallopian Tube Patency Tests; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D007247:Infertility, Female / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D010535:Laparoscopy / Q000379:methods*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014463:Ultrasonography