Evaluation of methods for tubal patency in female infertility

Evaluation of tubal patency is one of the important items in the investigation of female infertility. The methods we used are: hydrotubation (HT) , injection of saline solution; hysterosal -pingography (HSG), injection of iodized oil; and laparoscopy (LS), injection of methylene blue solution during laparoscopy. A total of 1 145 times were performed, HT 679, HSG 329 and LS 137. Contraindications were ruled out before each procedure. Patients were all followed at least up to 1 year after the procedure. The reliability of these methods were compared. 165 cases had HSG after HT. Results coincide, patent and nonpatent, in 137 but not in 28. The reliability rate for HT is 83%;50 cases had HSG and LS. 41 coincide but in 9 HSG accurate in 5 and LS in 4. So the reliability for HSG is 92% while that of LS is 90%.HT is simple and could be performed in any gynecologic clinic. It only shows that the tubes are patent or not, and a nonreliability of 17%. The reliability of HSG and LS are high. HSG besides showing tubal patency also shows the uterine cavity and tubal lining which helps in the pathological diagnosis such as tuberculosis. It also leaves a permanent record for further references. Laparoscopy gives a clear view of adhesions around the uterus and tubes, and particularly useful in the diagnosis of endometriosis. However, limitations will be encountered when adhesions are extensive preventing clear observation. The advantages and disadvantages of these methods were discussed. Their usefulness depends on the art of selection.The pregnancy rate after HT, HSG and LS are 24. 5% , 26. 0% and 34. 7% respectively. One phenomenon in common is that pregnancy rate within 6 months after the procedure are 44. 9%, 62. 0% and 50. 0% respectively. Emphasis made on planned investigation and full use of this optimum time after the procedure to increase the result of pregnancy.