THE ROLE OF 5.1\LINE CONTRAST SONOHYSTEROGRAPHY, HYSTEROSALPINGOGRAPHY AND DIAGNOSTIC HYSTEROSCOPY IN ASSESSMENT Of THE FALLOPIAN TUBES AND UTERINE CAVITY IN SECONDARY INFERTILE PATIENTS

Abstract

Infertility is defined as failure of conception despite free unprotected sexual life, some call it sterility. The commonest causes of tubal factor of infertility include pelvic inflammatory diseases where the sequalae resulting from salpingitis. This study aims to evaluate the role of hysterosalpingography, sonohysterography and diagnostic hysteroscopy in uterine cavity and fallopian tube assessment and to compare all of these parameters in the diagnostic work-upof secondary infertile patients.The methods used in this study to assess the uterine cavity and the fallopian tubes in secondary patients include hysterosalpingography. Sonohysterography is another method of assessment in our study, it arises from the demonstration -of the accuracy of pelvic ultrasonography in .diagnosing abnormalities of the uterine cavity and to a lesser extent abnormalities of the fallopian tubes Our study included 50 patients in Kasr El Aini outpatient clinic, assessed with hysterosalpingography, sonohysterography and diagnostic hysteroscopy as gold standard in the fallopian tube.Patients were divided into two groups, Group A assessment of uterine cavity Group B assessment of fallopian tubeThus, sonohysterography offers a number of benefits over hysterosalpingography as a screening test in infertile patients. A number of hysteroscopic studies have demonstrated that the use of hysterosalpingography results in a high rate of false positive findings, additionally it is difficult to make a definitive diagnosis when interpreting hysterograms, we found that although hysterosalpingography was diagnostic for intrauterine synechiae, most other cavitary defects require further evaluation. The use of sonohysterography may reduce unnecessary hysteroscopies performed for false-positive or misleading findings as hysterosalpingography.Therefore, sonohysterography provides a sensitive and specific method of screening the uterine cavity and fallopian tubes in infertile patients and although hysterosalpingography has been the standard screening test in infertility, the relatively low sensitivity and specificity of hysterosalpingography may favour the use of sonohysterography, for intrauterine screening. Being simple, safe, inexpensive and accurate technique for investigation of the uterine cavity and fallopian tubes and diagnostic hysteroscopy should be preserved for cases with abnormal findings in the sonohysterogram.