Comparison of hysterosalpingography and transvaginal hydrolaparoscopy in patients with tubal factor infertility: A prospective cohort study

Abstract

Aim: To evaluate the usefulness, diagnostic accuracy, and cost-effectiveness of transvaginal hydrolaparoscopy (THL)in infertile women with abnormal hysterosalpingogram (HSG) results without obvious pelvic pathology.Material and methods: Thirty infertile women (age: 20-40 years) who had tubal pathology in HSG were enrolled inthe study. All patients underwent THL instead of standard laparoscopy. A cost analysis was performed comparingHSG and THL methods. Results: In comparison of the HSG of cases by considering the chromopertubation results by THL, the sensitivityand specificity of HSG were 85.1% and 56%, respectively. The reasons for preferring standard laparoscopy ratherthan THL were: failure in accessing of Douglas (n = 3), insufficient monitoring of pelvis (n = 1), hydrosalpinx(n = 1), and intense peritubal adhesion (n = 1), which were 10%, 3%, 3%, and 3%, respectively. The complicationrate was 3.8%. Cost analysis of the procedures showed that the total cost of the THL group was 34.8% lowerthan the HSG group. Conclusions: In the elective patients group, THL is more feasible than HSG. Transvaginal hydrolaparoscopy is effective,simple and safe, avoiding the cost, possible complications, time and postoperative patient discomfort compared to conventional laparoscopy.