Can ultrasound-based investigations replace laparoscopy and hysteroscopy in infertility?

Kim Hauge, Kari Flo, Maria Riedhart, S. Granberg
In: European Journal of Obstetrics & Gynecology and Reproductive Biology · 2000 · vol. 92(1) , pp. 167–170 · doi:10.1016/s0301-2115(00)00442-5 · PMID:10986452 · W1993320500
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This paper evaluates the diagnostic accuracy of ultrasound investigations compared to laparoscopy and hysteroscopy for infertility assessments.

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Abstract

ObjectivesTo compare the use a simplified ultrasound based infertility investigation of the infertile couple with the current use of laparoscopy and hysteroscopy.Study designThirty-three infertile couples underwent transvaginal ultrasound and hystero-salpingo-contrast-sonography. A diagnosis was formulated based on the results of the ultrasound investigations, a semen analysis and endocrine parameters. The following day, all subjects underwent a laparoscopic chromotubation and hysteroscopy by a surgeon unaware of the ultrasound findings. A diagnosis based on the findings at laparoscopy and hysteroscopy, the same semen analysis and endocrine parameters, was then made. The two diagnoses were compared.ResultsA 90.9% agreement was found between the diagnoses made from the two methods used. When considering laparoscopic diagnosis the Gold Standard of tubal patency, the sensitivity to diagnose occluded tubes using hystero-contrast-sonography was 92.8%. The corresponding figures for specificity, PPV and NPV were 96.2%, 92.8% and 98.1%, respectively.ConclusionsA simple, ultrasound based approach to investigate the infertile couple, can be used effectively as an initial examination modality during the couple's work-up. However, there is a need for a larger study to confirm these results.

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