Hysterosonography using saline solution with atmospheric air to evaluate tubal permeability in women in propaedeutic for infertility

Abstract

Introduction: Tubal pathologies correspond to about 35% of infertility cases. Several methods are used for their investigation, the gold standard test being videolaparoscopy (VLP) with chromopertubation. Hysterosalpingography (HSG) is the method most widely used, however, it only indirectly analyses the endometri-al cavity, without providing information on other pathologies. On the other hand, Hysterosonosalpingography (HSNSG) utilizes non-ionizing contrast media and allows for a detailed analysis of the endometrial cavity, uterine tube permeability, and other pathologies of the uterus, ovaries, and adnexa. This is achieved through the use of Endovaginal Ultrasonography (USEV), which demonstrates comparable accuracy to other methods. Objectives: To evaluate tubal permeability through HSNSG, using saline solution with atmospheric air as contrast, and com-pare with those of HSG. Methods: Observational cross-sectional study with 28 patients with infertility: HSNSG results were compared with HSG, using Kappa’s method to calculate the level of agreement. Questionnaires were also taken to assess the level of pain and discomfort of the examination. Results: The analysis of the right tube had 75% agreement with the HSG with p=0.05 Kappa=0.364 (fair agreement), and 84.7% for the left tube, with p=0.0003 and Kappa=0.674 (substantial agreement). There were 18 (38.9%) cases of tube obstruction at HSG with normal tubes at HSNSG. Regarding the level of discomfort, 64.2% reported mild discomfort, 28.6% moderate and 7.2% intense discomfort. Conclusion: HSNSG has good correlation to HSG and may be the first-line test for investigating tubal permeability in the evaluation of infertile couples.