The diagnostic value of hysterosalpingo-contrast sonography in female infertility of the fallopian tube

Objective: To explore the clinical diagnostic value of hysterosalpingo-contrast sonograghy (HyCoSy) in female infertility of the fallopian tube.

Methods: One hundred nineteen female infertility patients who underwent laparoscopy in Shenzhen Hospital of Beijing University of Chinese medicine (Longgang) and Longgang District People’s Hospital of Shenzhen City from June 2019 to December 2021. Patients diagnosed with fallopian tube obstruction; 119 patients included 233 fallopian tubes (five patients had the affected fallopian tubes removed due to ectopic pregnancy) were selected for HyCoSy, and then the results of laparoscopic examination were taken as the gold standard for diagnosis. The authenticity of the diagnostic test was evaluated using four grid table data, and the consistency of the two diagnostic methods of hysterosalpingography and laparoscopy was compared by Kappa test.

Results: Of the 233 fallopian tubes assessed, 139 were unobstructed, 50 were blocked at the proximal end and 44 were blocked at the distal end by laparoscopy. The results of HyCoSy showed that 115 were unobstructed, seventy three was considered proximal obstruction and 45 were distal obstruction. When compared to laparoscopy, the accuracy of HyCoSy in the diagnosis of tubal patency, proximal obstruction and distal obstruction was 74.2%, 78.1% and 80.7%, respectively. Two methods had good consistency in the diagnosis of tubal patency (Kappa=0.486) and proximal tubal obstruction (Kappa=0.444), and poor consistency in the diagnosis of distal tubal obstruction (Kappa=0.375).

Conclusion: Laparoscopy and HyCoSy are both useful in the diagnosis and etiological analysis of female infertility. HyCoSy can be the first choice, those who have doubts about the screening results can actively carry out laparoscopy to further improve the accuracy of diagnosis and etiological analysis of this disease.