Hysterosalpingography versus sonohysterography for intrauterine abnormalities.
OBJECTIVE
The hysterosalpingogram is commonly used to evaluate the uterine cavity and the fallopian tubes in the workup of infertile couples. The sonohysterogram is gaining popularity as part of this evaluation. This study compares hysterosalpingography to sonohysterography  for the detection of polyps, cavitary fibroids, adhesions, and septae in infertile patients.


METHODS
We conducted a retrospective chart review of 149 infertility patients seen at a University Hospital Center, divisions of Reproductive Endocrinology and Interventional Radiology.  Patients underwent hysterosalpingography and sonohysterography as part of their infertility evaluation. The reports were reviewed and findings like polyps, fibroids, adhesions, and septae were compared to the findings obtained at the time of hysteroscopy. Sensitivity, specificity, and accuracy  of radiologic tests were the main outcome measures.


RESULTS
The sensitivity of hysterosalpingography and sonohysterography was 58.2% and 81.8%, respectively. The specificity for hysterosalpingography and sonohysterography was 25.6% and 93.8%. The differences in sensitivity and  specificity were both statistically significant. Hysterosalpingography had a general accuracy of 50.3%, while sonohysterography had a significantly higher accuracy of 75.5%.


CONCLUSIONS
Although hysterosalpingography is the standard screening test for the diagnosis of tubal infertility  and can provide useful information about the uterine cavity, sonohysterography is more sensitive, specific, and accurate in the evaluation of the uterine cavity.
St. Luke's-Roosevelt Hospital, New York, NY, USA. uacholon@cphnet.org
Uchenna C
UC
Acholonu
James
J
Silberzweig
Daniel E
DE
Stein
Martin
M
Keltz
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D015907:Hysteroscopy / Q000379:methods*; D007247:Infertility, Female / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*; D014591:Uterine Diseases / Q000000981:diagnostic imaging*