Open AccessHysteroscopy is superior to hysterosalpingography in infertility investigation
Author(s) -
Golan Abraham,
Eilat Eran,
Ronel Rafael,
Herman Arieh,
Soffer Yigal,
Bukovsky Ian
Publication year - 1996
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.3109/00016349609054692
Subject(s) - hysterosalpingography , hysteroscopy , medicine , uterine cavity , infertility , endoscopy , laparoscopy , predictive value , gynecology , obstetrics , radiology , pregnancy , uterus , genetics , biology
Background. The development of advanced endoscopic instrumentation in recent years has demonstrated the superiority of direct visual examination over radiographic demonstration of various body cavities. Just as laparoscopy has gradually taken a primary role in the surgical investigation of the ovulatory infertile patient, the role of intrauterine endoscopy in comparison to hysterosalpingography (HSG) needs to be reevaluated. Methods. Four hundred and sixty‐four infertile women had undergone both hysterosalpingography and a diagnostic hysteroscopy and the findings were analysed. Results. Compared to hysteroscopy the sensitivity of HSG was 98%, but its specificity only 15%, the positive predictive value 45%, and negative predictive value 95%. On hysteroscopy a normal uterine cavity was found in 53% of the cases with a filling defect and in 56% of those with uterine wall irregularity on HSG. Conclusions. Hysteroscopy, a safe and rapid direct visualisation of the uterine cavity, is superior to HSG in the identification of intrauterine pathology. In view of the low positive predictive value and the low specificity of the HSG, we believe it should be replaced by the diagnostic hysteroscopy as a first line infertility investigation.