Comparison of Hysterosalpingography and Diagnostic Laparoscopy in the assessment of tubal patency for the investigation of subfertility


Background: Infertility is common in our community . Infertility has become nowadays not only a medical, but a social problem as well .Fallopian tube problem is among one of the common causes of infertility. Hysterosalpingography and laparoscopy are used as a screening test for diagnosis of tubal patency .Hysterosalpingography is an out patient X-ray procedure, has for many years been an invaluable procedure for the assessment of tubal pathology and intra-uterine pathology.Laparoscopy is an invasive procedure used since 1944 by Raoul Palmer,of Paris for gynecological examination.Aim: We aimed in this paper to explore the role of hystrosalpingography in the evaluation of tubal patency in the diagnosis of the cause of female infertility in our society and to reduce the need for laparoscopy .Patients, materials and methods: One hundred fifty seven infertile women with fallopian tubes problem out of one thousand three hundred fifty patients who underwent HSG had given consent to undergo Laparoscopy in Sulaimaniea Maternity Teaching Hospital and in Hatwan Private Hospital during 2nd may. 2007 to 3rd may. 2008. For infertility not less than 2 years duration.Results: 1350 infertile patients with age range ( 20 – 39 ys ) underwent HSG, 157 patients show pathology of the fallopian tubes. Diagnostic laparoscopy was performed for them after the HSG procedure to confirm the abnormalities diagnosed by HSG. ,The results showed non insignificant difference P value, the HSG gave 92,4% sensitivity and 100% specificity, while laparoscopy showed 100% sensitivity and 100% specificity.Conclusion:We conclude the feasibility of using HSG as a diagnostic method for investigating tubal patency in subfertile women when compared to the use of diagnostic laparoscopy.