Diagnostic accuracy of hysterosalpingography in comparison to laparoscopy to detect tubal occlusion in female infertility: An observational study

Subrata Das, Ajit R Bhattacharyya

Abstract


Background: An accurate diagnosis of tubal occlusion is a crucial part of infertility management of women for which Hysterosalpingography is an integral part for this purpose.
Objective: The study is designed to find out tubal occlusion by hysterosalpingography (HSG) and comparing the findings with diagnostic laparoscopy with chromopertubation (laparoscopy) by determining validity and agreement of findings in the study group.
Materials and Methods: In this observational study, one hundred and ninety-seven women with infertility were recruited from an infertility clinic of a tertiary care hospital ofWest Bengal, in between April 2018 and March 2020, i.e. 24 months’ period. Women, who were exposed to both of the investigations i.e. HSG and laparoscopy tests, were our study subjects. HSG findings were compared with the findings of laparoscopy to detect tubal occlusion by analyzing sensitivity, specificity, positive predictive value, negative predictive value and kappa.
Results: We found mean age of women with primary infertility (66%) was 27.23 years and with secondary infertility (34%) was 32.02 years. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of HSG in comparison to laparoscopy to detect tubal occlusion were 80.85%, 74%, 49.35%, 92.5% and 75.63% respectively. Findings showed statistically significant (p<0.05) detection of tubal occlusion by HSG in comparison to findings of laparoscopy. Here tubal factor denotes any form of
tubal obstruction i.e. unilateral or bilateral.
Conclusion: This study provides strong supportive evidence to utilise HSG as a screening test for diagnosing tubal occlusion in infertility work up with high accuracy, especially in low resourceful area of rural India.

Keywords: Infertility, Hysterosalpingography, Laparoscopy, Chromopertubation.


Full Text:

PDF