title: Three-Dimensional Hysterosalpingo-Contrast-Sonography for the Assessment of Tubal Patency in Women with Infertility: A Systematic Review with Meta-Analysis.
abstract: OBJECTIVE
  We aimed at performing a systematic review to determine the diagnostic accuracy of three-dimensional (3D) hysterosalpingo-contrast-sonography (HyCoSy) for detecting tubal occlusion.
  
  
  METHODS
  A systematic review in Medline database search from January 1989 to October 2015 to identify relevant studies evaluating 3D-HyCoSy. Eligibility criteria were studies assessing the role of 3D-HyCoSy for diagnosing tubal occlusion in infertile women. Index test was 3D-HyCoSy. Reference standard was laparoscopy with dye test or X-ray hysterosalpingography. Quality was assessed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled sensitivity and specificity for the method were estimated.
  
  
  RESULTS
  A total number of 88 papers were identified. After exclusions, nine studies were ultimately included. Pooled estimated sensitivity was 98% (95% CI 91-100) with a moderate heterogeneity (I2: 64.8%, 95% CI 39.6-89.9; and Cochran Q 22.7, p < 0.001). Pooled estimated specificity was 90% (95% CI 83-95) with significant heterogeneity (I2: 80.3%, 95% CI 68.1-92.5; and Cochran Q 40.6, p < 0.001). Positive likelihood ratio was 10.3 (95% CI 5.6-18.7) and negative likelihood ratio was 0.02 (95% CI 0.00-0.21).
  
  
  CONCLUSIONS
  3D-HyCoSy is an accurate test for diagnosing tubal occlusion in women with infertility.
authors.affiliation: Department of Obstetrics and Gynecology, Clx00ED;nica Universidad de Navarra, School of Medicine, University of Navarra, Pamplona, Spain.
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Alcázar
authors.forename: Txanton
authors.initials: T
authors.lastname: Martinez-Astorquiza Corral
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Orozco
authors.forename: Jaime
authors.initials: J
authors.lastname: Dominguez-Piriz
authors.forename: Leire
authors.initials: L
authors.lastname: Juez
authors.forename: Tania
authors.initials: T
authors.lastname: Errasti
mesh_terms: D003287:Contrast Media; D005184:Fallopian Tube Diseases / Q000000981:diagnostic imaging*; D005186:Fallopian Tube Patency Tests / Q000379:methods*; D005187:Fallopian Tubes / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000000981:diagnostic imaging*; D010535:Laparoscopy; D016239:MEDLINE; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*; D014599:Uterus / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media