The safety and acceptability of saline infusion sonography versus hysterosalpingography for evaluation of tubal patency in infertile women

ObjectiveTo assess the efficacy, safety and acceptability of saline infusion sonography (SIS) in comparison to hysterosalpingography (HSG) in the evaluation of tubal patency in infertile women.Materials and methodsIn this prospective study, 104 consecutive infertile women underwent SIS and HSG for tubal patency followed by laparoscopy with dye test as the gold standard test. Test parameters, safety and acceptability of both methods were assessed.ResultsSIS showed patency in 90 (86.5%) tubes, HSG in 85 (81.7%) tubes, and laparoscopy in 75 (72.1%) tubes. SIS and laparoscopy agreed in 15 out of 29 occluded tubes (concordance, 51.7%) while HSG and laparoscopy agreed in 11 out of 29 occluded tubes (concordance, 37.9%). The sensitivity, specificity, PPV, NPV were 52%, 95%, 79%, 84% for SIS and 38%, 96%, 79%, 80% for HSG respectively. There were a significant number of women who experienced pain, syncopy and cervicovaginal lacerations during HSG examination in comparison to SIS (P < 0.001). SIS was more acceptable than HSG as a screening test for tubal patency regarding the overall discomfort and the overall satisfaction rate.ConclusionAlthough HSG is the standard screening test for the diagnosis of tubal infertility, the present study confirmed the higher sensitivity, safety and acceptability of SIS compared to HSG for the evaluation of tubal patency in infertile women.