Confirmation of tubal patency in hysterosalpingo-contrast sonography by transvaginal hydrolaparoscopy

Abstract

Objective. To confirm tubal patency in hysterosalpingo-contrast sonography (HyCoSy) by transvaginal hydrolaparoscopy (THL). Design. A prospective study. Setting. Infertility clinic at a university hospital. Population. Fifty-six infertile women with a history of tubal risk factor(s) who underwent HyCoSy and THL between 2003 and 2006. Methods. After performing HyCoSy, the tubal patency was verified by THL. Results. Altogether, 51 women and 101 tubes could be examined. Using HyCoSy, 61 of the tubes were considered patent and 40 occluded. THL confirmed 82 tubes patent and 19 occluded. Of 61 tubes found to be patent in HyCoSy, 60 were also patent in THL. In contrast, of 40 tubes occluded in HyCoSy only 18 tubes were confirmed to be occluded by THL. The concordance was 77%. The sensitivity of HyCoSy was 95%, the specificity 73%, the negative predictive value 98% and the positive predictive value 45%. Conclusions. HyCoSy is a reliable method when tubal patency is demonstrated. In cases of suspected tubal occlusion, THL is an inexpensive and safe outpatient procedure to exclude benign tubal spasm and confirm the presence of true occlusion. © 2009 Informa UK Ltd. (Informa Healthcare, Taylor & Francis AS).