Hysterosalpingo-contrast sonography: is possible to quantify the therapeutic effect of a diagnostic test?

Emilio Giugliano, Elisa Cagnazzo, Elisa Bazzan, Alfredo Patella, Roberto Marci, Emilio Giugliano, Elisa Cagnazzo, Elisa Bazzan, Alfredo Patella, Roberto Marci

Abstract

Objective: To evaluate the effect of hysterosalpingo-contrast sonography (HyCoSy) on natural conception in the infertile patient.

Methods: We conducted a prospective observational study recruiting 180 patients admitted to Infertility Center of Ferrara University from January 2010 to February 2012. The essential inclusion criteria was the couple's desire to perform only diagnostic evaluation on infertility causes and to wait for natural conception before proceeding with further management. Couples were investigated with hormonal profile, semen analysis and HyCoSy. Expected time for spontaneous pregnancy was 180 days from HyCoSy. First datation sonography of pregnancy was used calculating time elapsed from HyCoSy at conception.

Results: Forty patients (22.2%) obtained spontaneous pregnancy within 6 months after HyCoSy. The mean of "conception time" was 75 days. The pregnancy rate was significantly higher in the first 30 days (45%) compared to other the months of observation (p<0.0005). Multiple linear regression analysis showed that maternal age and sterility duration proved independent variables in detecting the "conception time" after HyCoSy (t=3.742, p=0.001, t=2.371, p=0.02, respectively).

Conclusion: A possible beneficial effect of HyCoSy is feasible especially in the days following its execution. This temporal correlation supports its therapeutic use.

Keywords: Fallopian tubes; Human; Hysterosalpingography; Sonography; Sterility.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
"Time conception" in the study population. HyCoSy, hysterosalpingo-contrast sonography.

References

    1. Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril. 2009;92:1520–1524.
    1. Das S, Nardo LG, Seif MW. Proximal tubal disease: the place for tubal cannulation. Reprod Biomed Online. 2007;15:383–388.
    1. ESHRE Capri Workshop Group. Diagnosis and management of the infertile couple: missing information. Hum Reprod Update. 2004;10:295–307.
    1. Wahby O, Sobrero AJ, Epstein JA. Hysterosalpingography in relation to pregnancy and its outcome in infertile women. Fertil Steril. 1966;17:520–530.
    1. Nugent D, Watson AJ, Killick SR, Balen AH, Rutherford AJ. A randomized controlled trial of tubal flushing with lipiodol for unexplained infertility. Fertil Steril. 2002;77:173–175.
    1. Lindborg L, Thorburn J, Bergh C, Strandell A. Influence of HyCoSy on spontaneous pregnancy: a randomized controlled trial. Hum Reprod. 2009;24:1075–1079.
    1. Luciano DE, Exacoustos C, Johns DA, Luciano AA. Can hysterosalpingo-contrast sonography replace hysterosalpingography in confirming tubal blockage after hysteroscopic sterilization and in the evaluation of the uterus and tubes in infertile patients? Am J Obstet Gynecol. 2011;204:79.e1–79.e5.
    1. Cao XW, Lin K, Li CY, Yuan CW. A review of WHO laboratory manual for the examination and processing of human semen (5th edition) Zhonghua Nan Ke Xue. 2011;17:1059–1063.
    1. Luttjeboer F, Harada T, Hughes E, Johnson N, Lilford R, Mol BW. Tubal flushing for subfertility. Cochrane Database Syst Rev. 2007;(3):CD003718.
    1. Chenia F, Hofmeyr GJ, Moolla S, Oratis P. Sonographic hydrotubation using agitated saline: a new technique for improving fallopian tube visualization. Br J Radiol. 1997;70:833–836.
    1. Hamed HO, Shahin AY, Elsamman AM. Hysterosalpingo-contrast sonography versus radiographic hysterosalpingography in the evaluation of tubal patency. Int J Gynaecol Obstet. 2009;105:215–217.
    1. Simpson WL, Jr, Beitia LG, Mester J. Hysterosalpingography: a reemerging study. Radiographics. 2006;26:419–431.
    1. Noorhasan D, Heard MJ. Gadolinium radiologic contrast is a useful alternative for hysterosalpingography in patients with iodine allergy. Fertil Steril. 2005;84:1744.
    1. Saunders RD, Shwayder JM, Nakajima ST. Current methods of tubal patency assessment. Fertil Steril. 2011;95:2171–2179.
    1. Zain MM, Norman RJ. Impact of obesity on female fertility and fertility treatment. Womens Health (Lond Engl) 2008;4:183–194.

Source: PubMed

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