Saikat Tripathy1 , Animesh Naskar2 , Roshni Sethia3 , Rup Kamal Das4
BACKGROUND Approximately 15% of couple are affected by infertility. Tubal factor is one of the most frequent causes of infertility in women. As tubo-peritoneal factor is accountable for 30 - 40% of female infertility, evaluation of tubal patency is the basic investigation for assessment of female infertility. Hysterosalpingogram (HSG) and laparoscopy are the two most commonly conducted tests to evaluate the tubal factor of female infertility. The aim of the study was to compare hysterosalpingogram with laparoscopy in the diagnosis of tubal factor of female infertility. METHODS This is an observational cross-sectional study conducted among 80 infertile women either primary or secondary in the Department of Gynaecology and Obstetrics, R.G. Kar Medical College, Kolkata, a tertiary care hospital in North-East, over a period of one and half years (January 2018 to July 2019). Primary infertility incidence was 56.3% and that of secondary infertility was 43.8%. More than half the subjects (66.3%) were between 26 to 35 years of age. Mean age of the study population was 27.43 ± 5.14 years. The mean period of infertility (Mean ± S.D.) of patients was 4.3375 ± 2.3164. Both procedures were done in the same patient. HSG was done in preovulatory phase. Laparoscopy was performed under general anaesthesia. Data had been summarized as mean and standard deviation for numerical variables and count and percentages for categorical variables. RESULTS Association of spillage of dye in HSG vs. laparoscopy was statistically significant (p<0.0001). Association of tubal block in HSG vs. laparoscopy was also significant. Association of abnormal tubal architecture in HSG vs. abnormal tubal architecture in laparoscopy is statistically significant (p= 0.0111296452). Difference in uterine filling defect in HSG and fibroid in laparoscopy was statistically significant (p=0.0013005280). Laparoscopy shows presence of fibroid in more no. of cases. In diagnosis of peritubular adhesion and abnormal tubal architecture, laparoscopy was significantly better than HSG. CONCLUSIONS HSG and laparoscopy are the two classic methods for evaluation of tubal patency in infertile women and are complementary to each other. HSG is less invasive, less expensive, more informative with regard to tubal luminal architecture; whereas, laparoscopy is the gold standard for tubal assessment.
