Role of Hysterosalpingo-Contrast-Sonography In the Evaluation of Fallopian Tubes Patency

Abstract

The current trend for couples to defer childbirth to later ages has resulted in an increasing number of couples presenting with infertility problems. Women presenting with infertility undergo many laboratory tests and imaging studies to exclude endocrine disturbances ,congenital anomalies of the genital tract, uterine abnormality, and occlusion of the fallopian tubes. The latter is a common cause of infertility, found in up to 30% of women being evaluated for the inability to conceive.

Conventional HSG under fluoroscopy remains the most commonly used procedure to diagnose fallopian tube patency in women. However, conventional HSG exposes the reproductive organs of a potentially fertile woman to ionizing radiation. Furthermore, conventional HSG provides a limited evaluation of other causes of infertility, such as congenital uterine malformation, myometrial abnormalities (adenomyosis, leiomyomas), and extrauterine diseases (endometriosis, adhesions, pelvic infection, adnexal disease).

Initial sonographic examination of infertile patients especially if followed by HyCoSy, could avoid HSG in patients with patent Fallopian tubes.

Sonohysterography using intrauterine infusion of saline solution is known to provide accurate delineation of the endometrial cavity has also been proposed for the analysis of Fallopian tube patency.