A comparison of hysterosalpingography and endoscopy in evaluation of tubal function in infertile women

A comparison of hysterosalpingography (HSG) with endoscopy in the evaluation of tubal function in 117 infertile women is presented. Results were in accord in 55% of the patients. Correction for endoscopic error and the limitations of HSG increased the positive correlation to 74%. Twenty-three patients (20%) with abnormal findings at HSG were normal with endoscopy. Ten patients (8%) had normal HSG but abnormal endoscopic findings. Fifteen patients (12%) with positive findings by HSG had different positive findings at endoscopy. Additional endoscopic findings in 47 patients are listed. Review of 26 patients with endoscopy-confirmed endometriosis revealed that 14 (54%) had a normal HSG and normal history and pelvic examination. Although HSG should be the method of choice as part of the basic evaluation, an infertile woman should undergo endoscopy before the evaluation is considered complete or final.