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

Background: Infertility is a complex disorder with significant psychological and emotional impact. It affects 10-15% of couples in the reproductive age group. Hence, evaluation of female genital tract is an important part of workup of an infertile woman. The most commonly used methods are hysterosalpingography which exposes the patient to ionizing radiation and laparoscopy which is invasive. This calls for the need of a low risk method that would be suited for ambulatory application. Saline infusion sonohysterography is a cost-effective, safe, non-invasive and a rapid procedure to visualize the female pelvic organ in evaluation of infertility. The objective of this study was to compare diagnostic accuracy of saline infusion sonography (SIS) over conventional hysterosalingography (HSG) for evaluation of female infertility.Methods: Total 50 patients who presented to the gynecology OPD between 2018 to September 2019 for evaluation of infertility were included for the study. The results of the two procedures were compared.Results: For evaluation of uterine cavity, SIS had a sensitivity of 95%, specificity of 100%, PPV of 100%, NPV 75% and a sensitivity of 100%, specificity of 100%, PPV of 91%, NPV of 100% for tubal patency as compared to HSG.Conclusions: For evaluation of uterine cavity, SIS had a sensitivity of 95%, specificity of 100%, PPV of 100%, NPV 75% and a sensitivity of 100%, specificity of 100%, PPV of 91%, NPV of 100% for tubal patency as compared to HSG.

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Evaluation of tubal patency in infertile patients with saline infusion sonosalpingogram

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182411 ◽

2018 ◽

Vol 7 (7) ◽

pp. 2590

Author(s):

Deepa Shanmugham ◽

Ramadoss Kabilan Vidhyalakshmi ◽

Jessy Varghese

Keyword(s):

Predictive Value ◽

Saline Infusion ◽

Tubal Patency ◽

Infertile Women ◽

Acute Pelvic Inflammatory Disease ◽

Study Population ◽

Tubal Disease ◽

A Prospective Study ◽

Work Up ◽

Infertile Patients

Background: The incidence of tubal disease in infertility in India is as high as 40%. The aim of our study is to evaluate the diagnostic accuracy of Saline Infusion Sonosalpingogram (SSG) in the assessment of tubal patency in infertile patients with laparoscopy as the gold standard.Methods: This is a prospective study conducted in the department of obstetrics and gynaecology on 50 consecutive infertile patients. Patients with acute pelvic inflammatory disease were excluded from the study. After complete examination and basic infertility work up, the tubal patency testing by Saline Infusion Sonosalpingogram was performed on day 8 of the cycle, followed by diagnostic laparoscopy with chromopertubation to confirm the tubal patency.Results: Out of 50 enrolled patients, 3 were excluded during the course of study. Thus, the study population comprised of 47 infertile women. During our study, 42 patients had tubes patent on SSG, out of which 41 patients had patent tubes on laparoscopy. 2 patients with blocked tubes on SSG had patent tubes on laparoscopy. 3 patients had blocked tubes on both SSG and laparoscopy. On statistical analysis, the sensitivity of SSG in diagnosing tubal patency is 95.34%, specificity 75%, positive predictive value 97.65% and negative predictive value 60%.Conclusions: Saline Infusion Sonosalpingogram is a simple, safe, convenient procedure for assessment of tubal patency in infertile women. It can be included in basic infertility work up. Hence, laparoscopy can be reserved for patients with tubal block, suspected pelvic pathology and unexplained infertility.

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Accuracy of saline infusion sonography versus hysteroscopy in the evaluation of uterine cavity abnormalities in infertile women at CHRACERH, Yaounde, Cameroon

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184477 ◽

2018 ◽

Vol 7 (11) ◽

pp. 4355

Author(s):

Claude C. Noa Ndoua ◽

Etienne Belinga ◽

Gaspard G. Ayissi Ngah ◽

Junie N. Metogo ◽

Sandrine Mendibi ◽

...

Keyword(s):

Gold Standard ◽

Uterine Cavity ◽

Saline Infusion ◽

Diagnostic Modality ◽

Cross Sectional ◽

Predictive Values ◽

Saline Infusion Sonography ◽

Infertile Women ◽

Retrospective Data Collection ◽

Sensitivity Specificity

Background: Uterine cavity abnormalities are seen as a cause of infertility in around 10%-15% and can go up to 50% in women with recurrent implantation failure. Saline infusion sonohysterography (SIS) is a minimally invasive diagnostic modality in the evaluation but hysteroscopy remains the gold standard in the assessment of intra uterine cavity. The aim of this study was to compare the diagnostic accuracy of saline infusion sonography (SIS) considering hysteroscopy (HS) as the gold standard to evaluate uterine cavity pathologies in infertile women at CHRACERH.Methods: Authors carried out a cross-sectional, retrospective study, over 2 years, from the 1st January 2016 to the 31st December 2017, with retrospective data collection in 110 records of infertile patients subjected to an ultrasound assessment of uterine cavity using saline as the contrast medium with a 6.5-MHz transvaginal transducer. When SIS found intra uterine abnormality, HS was done on a later date, using a 5 mm Bettocchi hysteroscope. Sensitivity, specificity, accuracy, positive and negative predictive values of SIS and HS were compared using the SPSS 20 software.Results: The mean age and body mass index were respectively 39.3±7.8 years and 28.7±4.1 kg/m². The main findings both in SIS and Hysteroscopy were respectively polyps (n=61; 55.5% vs 52.7%; n=58), myomas (n=43; 39.1% vs 31.8%; n=35), intrauterine adhesions (n=18; 16.4% vs 21.8%; n=24). The overall sensitivity, specificity and accuracy of SIS were 81.2%, 86.9% and 86.5% respectively.Conclusions: SIS as a diagnostic tool in the evaluation of intrauterine lesions has a good accuracy and can therefore replace HS when this later is not available, especially in our African setting.

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A comparative study to evaluate diagnostic accuracy and correlation between saline infusion sonography, hysterosalpingography and diagnostic hysterolaparoscopy in infertility

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200356 ◽

2020 ◽

Vol 9 (2) ◽

pp. 669

Author(s):

Arti Tiwari ◽

Beenu Kushwah Singh ◽

Anuradha Mishra

Keyword(s):

Diagnostic Accuracy ◽

False Negative ◽

Screening Method ◽

Saline Infusion ◽

First Line ◽

Male Factor ◽

Gold Standard Method ◽

Saline Infusion Sonography ◽

Tubal Patency ◽

One Year

Background: Till date hysterosalpingography (HSG) remains the first-line method to detect tubal patency and to find out any uterine abnormalities in infertile female while diagnostic hysterolaparoscopy (DHL) is considered to be the gold standard method, it is during last decades only that saline infusion sonography (SIS)/ sonohysterography (SHG) has emerged as an efficacious method of checking tubal patency and uterine anatomy as well. The present study aims to compare all three methods viz- SIS, HSG and DHL and to evaluate the correlation between these methods.Methods: 98 infertile females of age group 18-35 years with normal Hormonal profile without any male factor infertility, were prospectively selected from the outpatient department of obstetrics and gynecology, GMH Rewa, Madhya Pradesh over one year from 1st August 2016 to 31st July 2017.Results: Diagnostic accuracy (sensitivity and specificity) of SIS was found to be more than HSG for both tubal patency and uterine abnormalities detection. SIS has less numbers of false positive and false negative rates as compared to HSG. DHL was found to be much superior to both SIS and HSG, also detected additional findings in multiple sites like pelvis, tubes and the uterus on the same setting which were missed on SIS and HSG.Conclusions: SIS may replace HSG as a first step screening method for tubal patency detection, as it has more diagnostic accuracy than HSG and better correlation with DHL and has many advantages and minimal disadvantages as compared to HSG.

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Saline infusion sonography and office hysteroscopy in the diagnosis of abnormal uterine bleeding

International Journal of Clinical Obstetrics and Gynaecology ◽

10.33545/gynae.2019.v3.i4c.306 ◽

2019 ◽

Vol 3 (4) ◽

pp. 154-156

Author(s):

Dr. Nitin Kulkarni ◽

Dr. Urjita S Thavare

Keyword(s):

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Saline Infusion ◽

Office Hysteroscopy ◽

Saline Infusion Sonography

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Transvaginal Ultrasonography and Saline Infusion Sonography Compared to Hysteroscopy for Diagnosis of Intracavity Lesion: A 4-Year Experience in Suburban Referral Hospital

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.06.10240 ◽

2020 ◽

Vol 103 (6) ◽

pp. 585-593

Keyword(s):

Predictive Value ◽

Final Diagnosis ◽

Saline Infusion ◽

Transvaginal Ultrasonography ◽

Histopathological Diagnosis ◽

Endometrial Polyps ◽

Saline Infusion Sonography ◽

Submucous Myoma ◽

Kappa Value ◽

Sensitivity Specificity

Objective: To evaluate the accuracy of transvaginal ultrasonography (TVS) and saline infusion sonography (SIS) in use for the diagnosis of endometrial polyps and submucous myoma compared to hysteroscopy. Histopathology was considered as the gold standard for final diagnosis. Materials and Methods: The present retrospective study was conducted at Bhumibol Adulyadej Hospital, Bangkok, Thailand between January 2014 and December 2017. Medical records of 150 patients who attended for hysteroscopy and histopathological diagnosis were reviewed. The accuracy of TVS and SIS for the diagnosis of endometrial polyps and submucous myoma were determined. Results: Out of 150 enrolled cases, endometrial polyp was the most frequent hysteroscopic finding in participants of the present study (92/150). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of TVS, SIS, and hysteroscopy compared to pathologic reports for detection endometrial polyps were 71.7% versus 93.5% versus 97.8%, 38.5% versus 52.2% versus 68.2%, 80.5% versus 88.7% versus 92.8%, 27.8% versus 66.7% versus 88.2%, and 64.4% versus 85.2% versus 92.1%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of TVS, SIS, and hysteroscopy for detection of submucous myoma were 81.6% versus 92.1% versus 94.7%, 66.7% versus 86.9% versus 100%, 77.5% versus 92.1% versus 100%, 72.0% versus 86.9% versus 90.9%, and 75.4% versus 90.2% versus 96.6%, respectively. The kappa value from TVS, SIS, and hysteroscopy when the histopathologic reports were overall intrauterine abnormalities, endometrial polyps and submucous myoma were 0.45/0.43/0.72, 0.77/0.76/0.89, and 0.92/0.92/1.00, respectively. Conclusion: Sensitivity, specificity, PPV, NPV, accuracy, and kappa value of SIS for detecting endometrial polyps and submucous myoma were better than TVS. Keywords: Ultrasonography, Saline infusion sonography, Hysteroscopy, Accuracy

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