Three-dimensional Hysterosalpingo Contrast Sonography with Lignosal as Contrast for Evaluation of Tubal Patency in the Infertile Women – An Observational Cohort Study

2019 ◽  
Vol 2 ◽  
pp. 4
Author(s):  
Chegondi V N Rao ◽  
Chegondi Sindhu ◽  
Murali Krishna Kota
Keyword(s):  
Three Dimensional ◽  
Second Phase ◽  
Imaging Method ◽  
Fallopian Tubes ◽  
Tubal Patency ◽  
Tubal Occlusion ◽  
Infertile Women ◽  
Institutional Review ◽  
Observational Cohort ◽  
Infertile Patients

Objectives The objectives of the study were to evaluate the two-dimensional (2D)/three-dimensional (3D) hysterosalpingo contrast sonography (HyCoSy) using lignosal (a mixture of lignocaine 2% jelly with normal saline) as a contrast agent for assessing fallopian tubal patency in infertile patients. Materials and Methods After obtaining the Institutional Review Board permission, a single center prospective study was conducted to evaluate the validity of 3D-HyCoSy with lignosal to assess the patency of fallopian tubes in infertile women. In total 540 infertile patients were recruited for this study. Bilateral fallopian tube patency was confirmed when fallopian tubes were seen as echogenic tubular structures with peritoneal spill under real-time 3D/2D-HyCoSy. Results In the first phase of the study, 2D-HyCoSy without 3D acquisition was made in 20 patients (40 tubes). 2D-HyCoSy with lignosal contrast shown tubal patency in 95% and radiographic hysterosalpingography (HSG) resulted in 97.5% tubal patency with 5% inconclusive results by HyCoSy. In the second phase, data from 520 patients showed bilateral tubal patency in 463 patients (89.03%), unilateral tubal occlusion in 49 patients (9.42%), and bilateral tubal occlusion in eight patients (1.53%). No untoward side effects were noticed and reported by the patients during and after the HyCoSy procedure with lignosal. Conclusions 3D-HyCoSy with lignosal allowed the entire length of the fallopian tubes to be seen as contrast moved through the fallopian tubes to the fimbrial end. A “shower” of contrast around the ovaries is visualized confirming the peritoneal spill. Use of lignosal provides an alternative imaging method for evaluating the tubal patency in infertile patients.

scholarly journals The value of hysterosalpingography in the diagnosis of tubal pathology among infertile patients

Medicina ◽  
2008 ◽  
Vol 44 (6) ◽  
pp. 439 ◽  
Author(s):  
Eglė Tvarijonavičienė ◽  
Rūta Nadišauskienė
Keyword(s):  
Cross Sectional Study ◽  
Likelihood Ratios ◽  
Cross Sectional ◽  
Tubal Patency ◽  
Tubal Occlusion ◽  
Infertile Women ◽  
Definition Of ◽  
Tubal Pathology ◽  
Test Result ◽  
Infertile Patients

Objective. To evaluate the diagnostic accuracy of hysterosalpingography in the diagnosis of tubal pathology among infertile patients. Patients and methods. A prospective cross-sectional study in Kaunas University of Medicine Hospital within the period of 18 months was performed. Consecutive infertile women formed the study group according to defined criteria. Hysterosalpingography was performed in the preovulatory phase of the menstrual cycle. Laparoscopy and dye test was performed within one – three months after hysterosalpingography. General tubal pathology, tubal occlusion, and peritubal adhesions detected at hysterosalpingography were compared with general tubal pathology, tubal occlusion, and peritubal adhesions detected at laparoscopy. Results. The study population comprised 149 infertile women. The sensitivity of 81.4% and specificity of 47.8% the likelihood ratio of a positive test result of 1.6 and a negative test result of 0.4 for hysterosalpingography while evaluating general tubal pathology was determined. Sensitivity of 84.1% and specificity of 59.1% and likelihood ratios of 2.1 and 0.3, respectively, were calculated, when tubal occlusion was defined as any abnormality of tubal patency. When definition of tubal occlusion was limited to two-sided occlusion, the sensitivity and specificity were 89.5% and 90% and likelihood ratios 9.0 and 0.1, respectively. As a test of peritubal adhesions, hysterosalpingography had sensitivity of 35.5% and specificity of 81.3% and likelihood ratios of 1.9 and 0.8, respectively. Conclusion. The diagnostic performance of hysterosalpingography in the diagnosis of general tubal pathology and peritubal adhesions is poor. Hysterosalpingography is more accurate in the diagnosis of tubal occlusion.

3D and 4D studies from human reproduction to perinatal medicine

2017 ◽  
Vol 45 (6) ◽  
Author(s):  
Sonal Panchal ◽  
Asim Kurjak ◽  
Chaitanya Nagori
Keyword(s):  
Prenatal Diagnosis ◽  
Congenital Malformations ◽  
Three Dimensional ◽  
Endometrial Receptivity ◽  
Human Reproduction ◽  
Fallopian Tubes ◽  
Perinatal Medicine ◽  
Tubal Patency ◽  
Pretreatment Assessment

AbstractThree-dimensional ultrasound (3D US) is a modality of choice for prenatal diagnosis of congenital malformations. But 3D-four-dimensional US(4D US) is of utmost importance also to achieve pregnancy. 3D US plays an important role for diagnosis of PCO, to assess ovarian reserve and response and thus to decide optimum stimulation protocols. It adds to the information on follicular maturity and endometrial receptivity, thus improving the chances to achieve pregnancy for patients under treatment for fertility. 3D hystero-contrast-salpingography (HyCoSy) has also proved itself to be one of the best modalities for assessment of tubal patency. In this article, the role of 3D and 4D US is discussed for the following. I. Pretreatment assessment of the females desiring fertility which includes assessment of uterus and fallopian tubes. II. Monitoring of infertile females undergoing treatment. III. Assessment of very early pregnancy – especially in abnormal locations.

scholarly journals Spontaneous conception outcome in infertile women after four-dimensional hysterosalpingo-contrast-sonography

2020 ◽  
Author(s):  
yu liu ◽  
ning zhang ◽  
yanni he ◽  
jiayao shi ◽  
meijun zhou ◽  
...  
Keyword(s):  
Conception Rate ◽  
Pelvic Surgery ◽  
Semen Parameters ◽  
Type I ◽  
Tubal Patency ◽  
Infertile Women ◽  
Spontaneous Conception ◽  
Type Iv ◽  
History Of ◽  
Infertile Patients

Abstract Background: Four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) is the preferred way for evaluating fallopian tubal patency and it associated with higher rate of spontaneous conception. However, Few studies have evaluated the influencing factors of spontaneous conception in 4D-HyCoSy and suggested ways to choose treatment options after 4D-HyCoSy. The study was to evaluate the correlation between spontaneous conception outcome and the patients’ clinical characteristics as well as tubal patency in infertile women to provide reference on ways to manage the patient after 4D-HyCoSy.Methods: This was a retrospective study and analysis of two hundred and eighty three (283) infertile patients who underwent a 4D-HyCoSy between December 2014 and October 2017 in our center. Eligible patients were those whose partners semen parameters were normal when based on World Health Organization(WHO) criteria, and had spontaneous conception without clinical interventions after 4D-HyCoSy.Result(s): One hundred and sixteen patients (40.9%) conceived spontaneously and the mean conception time was (8.8 ± 0.3) months. Within a year after 4D-HyCoSy, the spontaneous conception rate was highest in type VI(62.5%), followed by type IV (46.2%), type III (44.4%), type V (39.4%), type II (33.9%) and type I (14.8%). With Cox regression analysis, two factors associated with spontaneous conception outcome appeared to increase spontaneous conception rate: patients with type IV or type VI tubes and duration of infertility less than 2 years. The age, type of infertility, multiparas, history of pelvic surgery, history of uterine cavity operation, uterine fibromyomata and polycystic ovary were unrelated to spontaneous conception outcome after 4D-HyCoSy.Conclusion(s): This study showed that some infertile women could succeed in spontaneous conception after 4D-HyCoSy. Hence, We recommend the usage of 4D-HyCoSy as first line for tubal patency test and infertile patients should be advised to accept 4D-HyCoSy examination as soon as possible. Expectant treatment of about 8-9 months is reported to be feasible for infertile women whose 4D-HyCoSy findings showed one tube patency or poor patency. Alternatively, an immediate clinical intervention is recommended for those with bilateral obstructed tubes .

scholarly journals African experience of hysterosalpingography abnormalities tubes management by laparoscopy in infertile women

2019 ◽  
Vol 8 (11) ◽  
pp. 4271
Author(s):  
Mohamed Fanny ◽  
Edele Aka ◽  
Perel Konan ◽  
Luc Olou ◽  
Abdoul K. Koffi ◽  
...  
Keyword(s):  
Pelvic Surgery ◽  
Fallopian Tubes ◽  
Tubal Infertility ◽  
Tubal Patency ◽  
Infertile Women ◽  
African Experience ◽  
Gynecology And Obstetrics ◽  
Therapeutic Procedures ◽  
History Of ◽  
Sub Saharan

Background: Infertility affects about 80 million people worldwide and one in ten couples. The objective of this study was to report our experience of the contribution of laparoscopy in the diagnostic and prognostic approach of fallopian tubes pathology in infertile women in sub-Saharan Africa.Methods: We conducted a retrospective study in the Gynecology and Obstetrics unit of Yopougon Teaching Hospital over a 2-year period (January 1, 2017 to December 31, 2018) which included 49 cases of tubo-peritoneal infertility diagnosed by hysterosalpingography (HSG) then laparoscopy procedure.Results: The average age was 33 years old.  30.6 % were single. 75% had secondary infertility. 59.2% had a medical history of abortion. Pelvic Inflammatory Disease and pelvic surgery accounted 84.2% and 49 respectively. Laparoscopy showed a predominance of distal tubal damage (66.6%) whose 47% hydrosalpinx. Bilateral tubal patency was demonstrated in 77.5% of our patients during laparoscopy procedure. We observed a sensitivity, a specificity, and a concordance laparoscopy / HSG of 63.6%, 80% 63.1% respectively. Laparoscopy also allowed therapeutic procedures such as adhesiolysis or tubal plasty in 22 patients (44.89% of our cases). At the end of laparoscopy procedure, 35 patients (71.42%) were turned towards IVF.Conclusions: Laparoscopy allows an assessment of tubal abnormalities revealed by hysterosalpingography and the fertility prognostic as well as better therapeutic approach in management of tubal infertility.

scholarly journals Analysis of the Spontaneous Conception Outcome in Infertile Women After Four-dimensional Hysterosalpingo-Contrast-Sonography

2020 ◽  
Author(s):  
yu liu ◽  
ning zhang ◽  
yanni he ◽  
jiayao shi ◽  
meijun zhou ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Intervention ◽  
World Health ◽  
Pelvic Surgery ◽  
Cox Regression Analysis ◽  
Tubal Patency ◽  
Infertile Women ◽  
Spontaneous Conception ◽  
History Of ◽  
Infertile Patients

Abstract Background: to evaluate the correlation between spontaneous conception outcome and the patients’ clinical characteristics as well as tubal patency in infertile women after four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy).Methods:Two hundred and eighty three infertile patients performed 4D-HyCoSy between December 2014 and October 2017,based on a normal semen analysis according to World Health Organization criteria, spontaneous conception without clinical interventions after 4D-HyCoSy, were trying to become conception. We analyzed the relationship between spontaneous conception outcome and clinical characteristics and tubal patency of infertile women after 4D-HyCoSy.Result(s): One hundred and sixteen patients (40.9%) conceived spontaneously and the mean conception time was (8.8 ± 0.3) months. With Cox regression analysis, two factors associated with spontaneous conception outcome appeared to increase spontaneous conception rate: patients with type IV or type VI tubes and duration of infertility less than 2 years.The age, type of infertility, multiparas, history of pelvic surgery, history of uterine cavity operation, uterine fibromyomata and polycystic ovary were unrelated to spontaneous conception outcome after 4D-HyCoSy.Conclusion(s):This study showed that some infertile women could succeed in spontaneous conception after 4D-HyCoSy. Hence, infertile patients should be advised to accept 4D-HyCoSy examination as soon as possible and based on the 4D-HyCoSy they could chose the appropriate clinical intervention. According to the results, expectant treatment of about 8-9 months is reported to be feasible for infertile women whose 4D-HyCoSy findings showed one tube patency or poor patency, especially for those with bilateral tubes patency or bilateral tubes poor patency.Alternatively, an immediate clinical intervention is recommended for those with bilateralobstructed tubes.

scholarly journals Spontaneous conception outcome in infertile women after four-dimensional hysterosalpingo-contrast-sonography

2020 ◽  
Author(s):  
yu liu ◽  
ning zhang ◽  
yanni he ◽  
jiayao shi ◽  
meijun zhou ◽  
...  
Keyword(s):  
Conception Rate ◽  
Pelvic Surgery ◽  
Semen Parameters ◽  
Type I ◽  
Tubal Patency ◽  
Infertile Women ◽  
Spontaneous Conception ◽  
Type Iv ◽  
History Of ◽  
Infertile Patients

Abstract Background: Four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) is the preferred way for evaluating fallopian tubal patency and it associated with higher rate of spontaneous conception. However, Few studies have evaluated the influencing factors of spontaneous conception in 4D-HyCoSy and suggested ways to choose treatment options after 4D-HyCoSy. The study was to evaluate the correlation between spontaneous conception outcome and the patients’ clinical characteristics as well as tubal patency in infertile women to provide reference on ways to manage the patient after 4D-HyCoSy.Methods: This was a retrospective study and analysis of two hundred and eighty three (283) infertile patients who underwent a 4D-HyCoSy between December 2014 and October 2017 in our center. Eligible patients were those whose partners semen parameters were normal when based on World Health Organization(WHO) criteria, and had spontaneous conception without clinical interventions after 4D-HyCoSy.Result(s): One hundred and sixteen patients (40.9%) conceived spontaneously and the mean conception time was (8.8 ± 0.3) months. Within a year after 4D-HyCoSy, the spontaneous conception rate was highest in type VI(62.5%), followed by type IV (46.2%), type III (44.4%), type V (39.4%), type II (33.9%) and type I (14.8%). With Cox regression analysis, two factors associated with spontaneous conception outcome appeared to increase spontaneous conception rate: patients with type IV or type VI tubes and duration of infertility less than 2 years. The age, type of infertility, multiparas, history of pelvic surgery, history of uterine cavity operation, uterine fibromyomata and polycystic ovary were unrelated to spontaneous conception outcome after 4D-HyCoSy.Conclusion(s): This study showed that some infertile women could succeed in spontaneous conception after 4D-HyCoSy. Hence, We recommend the usage of 4D-HyCoSy as first line for tubal patency test and infertile patients should be advised to accept 4D-HyCoSy examination as soon as possible. Expectant treatment of about 8-9 months is reported to be feasible for infertile women whose 4D-HyCoSy findings showed one tube patency or poor patency. Alternatively, an immediate clinical intervention is recommended for those with bilateral obstructed tubes .

scholarly journals Spontaneous conception outcome in infertile women after four-dimensional hysterosalpingo-contrast-sonography

2020 ◽  
Author(s):  
yu liu ◽  
ning zhang ◽  
yanni he ◽  
jiayao shi ◽  
meijun zhou ◽  
...  
Keyword(s):  
Conception Rate ◽  
Pelvic Surgery ◽  
Semen Parameters ◽  
Type I ◽  
Tubal Patency ◽  
Infertile Women ◽  
Spontaneous Conception ◽  
Type Iv ◽  
History Of ◽  
Infertile Patients

Abstract Background: Four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) is the preferred way for evaluating fallopian tubal patency and it associated with higher rate of spontaneous conception. However, Few studies have evaluated the influencing factors of spontaneous conception in 4D-HyCoSy and suggested ways to choose treatment options after 4D-HyCoSy. The study was to evaluate the correlation between spontaneous conception outcome and the patients’ clinical characteristics as well as tubal patency in infertile women to provide reference on ways to manage the patient after 4D-HyCoSy.Methods: This was a retrospective study and analysis of two hundred and eighty three (283) infertile patients who underwent a 4D-HyCoSy between December 2014 and October 2017 in our center. Eligible patients were those whose partners semen parameters were normal when based on World Health Organization(WHO) criteria, and had spontaneous conception without clinical interventions after 4D-HyCoSy.Result(s): One hundred and sixteen patients (40.9%) conceived spontaneously and the mean conception time was (8.8 ± 0.3) months. Within a year after 4D-HyCoSy, the spontaneous conception rate was highest in type VI(62.5%), followed by type IV (46.2%), type III (44.4%), type V (39.4%), type II (33.9%) and type I (14.8%). With Cox regression analysis, two factors associated with spontaneous conception outcome appeared to increase spontaneous conception rate: patients with type IV or type VI tubes and duration of infertility less than 2 years. The age, type of infertility, multiparas, history of pelvic surgery, history of uterine cavity operation, uterine fibromyomata and polycystic ovary were unrelated to spontaneous conception outcome after 4D-HyCoSy.Conclusion(s): This study showed that some infertile women could succeed in spontaneous conception after 4D-HyCoSy. Hence, We recommend the usage of 4D-HyCoSy as first line for tubal patency test and infertile patients should be advised to accept 4D-HyCoSy examination as soon as possible. Expectant treatment of about 8-9 months is reported to be feasible for infertile women whose 4D-HyCoSy findings showed one tube patency or poor patency. Alternatively, an immediate clinical intervention is recommended for those with bilateral obstructed tubes .

scholarly journals Combined Real-Time Three-Dimensional Hysterosalpingo-Contrast Sonography with B Mode Hysterosalpingo-Contrast Sonography in the Evaluation of Fallopian Tube Patency in Patients Undergoing Infertility Investigations

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Sumin Chen ◽  
Xiya Du ◽  
Qingzi Chen ◽  
Shaoqi Chen
Keyword(s):  
Contrast Agent ◽  
Real Time ◽  
Three Dimensional ◽  
Kappa Coefficient ◽  
Fallopian Tubes ◽  
Agreement Rate ◽  
Tubal Patency ◽  
Medical College ◽  
Infertility Patients ◽  
Distal Occlusion

Objective. This prospective study aimed to investigate the use of real-time three-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy), using contrast agent SonoVue, with B mode hysterosalpingo-contrast sonography (B mode-HyCoSy), to evaluate tubal patency and the wall of the Fallopian tubes in infertility patients. Method. In total, we recruited 739 women with fertility requirements from the First Affiliated Hospital of Shantou Medical College between January 2017 and July 2018. All cases received 4D-HyCoSy using contrast agent SonoVue, immediately followed by the B mode-HyCoSy. Of these patients, 145 showed pathological findings in the Fallopian tubes during HyCoSy; 34 of these (62 Fallopian tubes) were verified by laparoscopy and the dye test against routine reference standards. Sonographic findings, along with laparoscopic findings and dye test results, were used to compare the two techniques using the Cohen kappa coefficient. We also investigated the duration of examination and pain score. Results. Compared with laparoscopy and the dye test, the tubal occlusion diagnostic accordance rates for 4D-HyCoSy were 88.7% (32+23)/62, with a kappa coefficient of 0.769 and a 76.9% agreement rate. Distal occlusion diagnostic accordance rates for 4D-HyCoSy were 100% (8/8) with a k coefficient of 1.000 and a 100% agreement rate. Conclusions. The use of 4D-HyCoSy, with B mode-HyCoSy, for the diagnosis of tubal patency is safe, feasible, noninvasive, and highly accurate. B mode-HyCoSy allowed us to observe tubal walls in an intuitive manner.

scholarly journals Spontaneous conception outcome in infertile women after four-dimensional hysterosalpingo-contrast-sonography

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yu Liu ◽  
Ning Zhang ◽  
Yanni He ◽  
Jiayao Shi ◽  
Meijun Zhou ◽  
...  
Keyword(s):  
Conception Rate ◽  
Pelvic Surgery ◽  
Semen Parameters ◽  
Type I ◽  
Tubal Patency ◽  
Infertile Women ◽  
Spontaneous Conception ◽  
Type Iv ◽  
History Of ◽  
Infertile Patients

Abstract Background Four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) is the preferred way for evaluating fallopian tubal patency and it associated with higher rate of spontaneous conception. However, Few studies have evaluated the influencing factors of spontaneous conception in 4D-HyCoSy and suggested ways to choose treatment options after 4D-HyCoSy. The study was to evaluate the correlation between spontaneous conception outcome and the patients’ clinical characteristics as well as tubal patency in infertile women to provide reference on ways to manage the patient after 4D-HyCoSy. Methods This was a retrospective study and analysis of two hundred and eighty three (283) infertile patients who underwent a 4D-HyCoSy between December 2014 and October 2017 in our center. Eligible patients were those whose partners semen parameters were normal when based on World Health Organization (WHO) criteria, and had spontaneous conception without clinical interventions after 4D-HyCoSy. Result(s) One hundred and sixteen patients (40.9%) conceived spontaneously and the mean conception time was (8.8 ± 0.3) months. Within a year after 4D-HyCoSy, the spontaneous conception rate was highest in type VI(62.5%), followed by type IV (46.2%), type III (44.4%), type V (39.4%), type II (33.9%) and type I (14.8%). With Cox regression analysis, two factors associated with spontaneous conception outcome appeared to increase spontaneous conception rate: patients with type IV or type VI tubes and duration of infertility less than 2 years. The age, type of infertility, multiparas, history of pelvic surgery, history of uterine cavity operation, uterine fibromyomata and polycystic ovary were unrelated to spontaneous conception outcome after 4D-HyCoSy. Conclusion(s) This study showed that some infertile women could succeed in spontaneous conception after 4D-HyCoSy. Hence, We recommend the usage of 4D-HyCoSy as first line for tubal patency test and infertile patients should be advised to accept 4D-HyCoSy examination as soon as possible. Expectant treatment of about 8–9 months is reported to be feasible for infertile women whose 4D-HyCoSy findings showed one tube patency or poor patency. Alternatively, an immediate clinical intervention is recommended for those with bilateral obstructed tubes .

scholarly journals Evaluation of tubal patency in infertile patients with saline infusion sonosalpingogram

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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