Objective: This study is designed to investigate the diagnostic value of trans-vaginal sonography performed directly after diagnostic hysteroscopy, for assessing tubal patency in infertile women, and to compare the findings with those obtained by means of laparoscopic chromopertubation.
Methods: A total of 60 infertile patients were referred to our endoscopic unit for laparoscopic chromopertubation in the period from march 2018 to march 2019. Diagnostic hysteroscopy, followed by TVS, was carried out prior to laparoscopic chromopertubation. The collection of free fluid in the pouch of Douglas was accepted as evidence of tubal patency. The findings of TVS and laparoscopic chromopertubation were compared. The data were analyzed for the sensitivity, specificity, accuracy, positive predictive value, and negative-predictive value of the combination of hysteroscopy and TVS in detecting unilateral or bilateral tubal patency.
Results: The presence of fluid in the pouch of Douglas was observed in 49 of the 60 cases. In all the 49 cases, unilateral or bilateral tubal patency was confirmed by laparoscopic chromopertubation. In 8 of the remaining 11 cases (without fluid in the pouch of Douglas during ultrasound), bilateral tubal occlusion was confirmed by laparoscopic chromopertubation. Diagnostic hysteroscopy followed by TVS showed a high sensitivity and specificity for the assessment of tubal patency
Conclusion: TVS performed directly after diagnostic hysteroscopy in infertile patients provides additional information regarding tubal patency