A Study Evaluation of Tubal Factors of Infertility by Hysterosalpingography and Diagnostic Laparoscopy

Background: Reproductive endocrinologist, consider a couple to be infertile if the couple has not conceived after 12 months of contraceptive free intercourse if the female is under the age of 34 years. The incidence of infertility in any community varies between 10-15 %. Tubal occlusion is one of the most frequent causes of infertility in women (20-40 %). The evaluation of the fallopian tube is necessary to determine the management plan for infertility. The two most diagnostic procedures which are used for the evaluation of tubal patency are hysterosalpingography and laparoscopy¹. Aims of this study were: To study the validity of hysterosalpingography, in detecting tubal factors in infertility, as compared to diagnostic laparoscopy. Material and Method: This descriptive study was conducted in the Department of Obstetrics and Gynecology in a tertiary health care center attached to a Medical College. A total number of 114 primary as well as secondary infertility patients were evaluated for tubal factors of infertility. All the infertility cases underwent HSG on day 8^th, 9^th and 10^th day of the menstrual cycles. Laparoscopic chromopertubation was done during proliferative phase of the next menstrual cycle. Statistical analysis was done using statistical package for social sciences ver.18. The result was expressed in mean and standard deviation. "Z" test for the difference between the two means were used. For qualitative data proportion and "Chi" test were used. For assessing the validity of HSG in diagnosing in tubal factors of infertility laparoscopy was used as a gold standard. For the purpose of this study, 95% confidence limit was chosen and corresponding p-value <0.05 was taken as statistically significant. Conclusion: In our study we found that Hysterosalpingography is simple, inexpensive, safe and rapid diagnostic modality for tubal patency then laparoscopy. Laparoscopy is considered the Gold Standard for diagnosing tubal and peritoneal disease. HSG and Laparoscopy are not alternative, but complimentary methods in the examination of tubal patency in case of infertility.