title: Hysterosalpingo-contrast-sonography (HyCoSy) in the assessment of tubal patency in endometriosis patients.
abstract: OBJECTIVE
  Tubal patency in women with endometriosis has traditionally been evaluated by laparoscopy. The aim of this study was to investigate the accuracy of hysterosalpingo-contrast-sonography (HyCoSy) in the assessment of tubal patency in these women.
  
  
  METHODS
  A retrospective study was conducted at Physiopathology of Human Reproduction Unit. Infertile women who underwent HyCoSy and then a laparoscopy (dye test) within 6 months from the HyCoSy were included. Tubal patency was assessed by HyCoSy and the findings were compared with the results of laparoscopy, which was considered the gold standard for assessment of tubal patency. Sensitivity, specificity, positive and negative predictive values (PPV, NPV) and positive and negative likelihood ratios (Lh+, Lh-) were calculated including the 95% confidence interval (CI).
  
  
  RESULTS
  A total of 1452 women underwent HyCoSy and 126 of them received a laparoscopy within 6 months from the HyCoSy. Of the 126 women, 42 (33.3%) had a diagnosis of pelvic endometriosis and 84 (66.7%) had no endometriosis. In the endometriosis population, HyCoSy showed a sensitivity, specificity, PPV, NPV, Lh+ and Lh- of 85% (95% CI 62-96), 93% (95% CI 82-97), 81% (95% CI 58-94), 94% (95% CI 84-98), 12.6 (95% CI 4.8-33) and 0.15 (95% CI 0.05-0.4) respectively. In the non-endometriosis group, HyCoSy showed a sensitivity, specificity, PPV, NPV, LR+ and LR- of 85% (95% CI 65-95), 93% (95% CI 87-96), 71% (95% CI 53-85), 97% (95% CI 92-99), 13.2 (95% CI 6.9-25) and 0.15 (95% CI 0.06-0.3) respectively. The diagnostic accuracy of HyCoSy was 91% in the endometriosis group and 92% in the non-endometriosis patients.
  
  
  CONCLUSIONS
  HyCoSy showed high accuracy in evaluating tubal patency in infertile non-endometriosis women and in those affected by endometriosis.
authors.affiliation: Institute of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: morofrancy@gmail.com.
authors.forename: Francesca
authors.initials: F
authors.lastname: Moro
authors.affiliation: Institute of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Tropea
authors.affiliation: Institute of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Selvaggi
authors.affiliation: Institute of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Scarinci
authors.affiliation: Institute of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lanzone
authors.affiliation: Institute of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Rosanna
authors.initials: R
authors.lastname: Apa
mesh_terms: D000328:Adult; D004396:Coloring Agents; D003287:Contrast Media; D004715:Endometriosis / Q000150:complications / Q000000981:diagnostic imaging*; D005184:Fallopian Tube Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D005186:Fallopian Tube Patency Tests / Q000379:methods*; D005187:Fallopian Tubes / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000000981:diagnostic imaging / Q000209:etiology; D010535:Laparoscopy; D010049:Ovarian Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging*
chemical_list: D004396:Coloring Agents; D003287:Contrast Media
keywords: Endometriosis; Fallopian tube patency tests; HyCoSy; Infertility; Laparoscopy