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Phillips CH, Benson CB, Ginsburg ES, et al. Comparison of uterine and tubal pathology identified by transvaginal sonography, hysterosalpingography, and hysteroscopy in female patients with infertility. Fertil Res Pract. 2015;1:20doi: 10.1186/s40738-015-0012-3.
Phillips, C. H., Benson, C. B., Ginsburg, E. S., & Frates, M. C. (2015). Comparison of uterine and tubal pathology identified by transvaginal sonography, hysterosalpingography, and hysteroscopy in female patients with infertility. Fertility research and practice, 120. https://doi.org/10.1186/s40738-015-0012-3
Phillips, Catherine H, et al. "Comparison of uterine and tubal pathology identified by transvaginal sonography, hysterosalpingography, and hysteroscopy in female patients with infertility." Fertility research and practice vol. 1 (2015): 20. doi: https://doi.org/10.1186/s40738-015-0012-3
Phillips CH, Benson CB, Ginsburg ES, Frates MC. Comparison of uterine and tubal pathology identified by transvaginal sonography, hysterosalpingography, and hysteroscopy in female patients with infertility. Fertil Res Pract. 2015 Dec 23;1:20. doi: 10.1186/s40738-015-0012-3. eCollection 2015. PMID: 28620525; PMCID: PMC5424419.
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Fertil Res Pract. 2015 Dec 23;1:20. doi: 10.1186/s40738-015-0012-3. eCollection 2015.

Comparison of uterine and tubal pathology identified by transvaginal sonography, hysterosalpingography, and hysteroscopy in female patients with infertility.

Fertility research and practice

Catherine H Phillips, Carol B Benson, Elizabeth S Ginsburg, Mary C Frates

Affiliations

  1. Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 USA.
  2. Department of Infertility and Reproductive Surgery, Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 USA.

PMID: 28620525 PMCID: PMC5424419 DOI: 10.1186/s40738-015-0012-3

Abstract

BACKGROUND: The causes of female infertility are multifactorial and necessitate comprehensive evaluation including physical examination, hormonal testing, and imaging. Given the associated psychological and financial stress that imaging can cause, infertility patients benefit from a structured and streamlined evaluation. The goal of such a work up is to evaluate the uterus, endometrium, and fallopian tubes for anomalies or abnormalities potentially preventing normal conception. To date, the standard method for assessing these structures typically involves some combination of transvaginal sonography (TVS), hysterosalpingography (HSG), and hysteroscopy (HSC). The goal of this review is to compare the diagnostic accuracy of TVS, HSG, and HSC for diagnosing abnormalities in infertility patients to determine if all studies are necessary for pre-treatment evaluation.

RESULTS: We identified infertility patients prior to initiation of assisted reproductive technology who had baseline TVS, HSG, and HSC within 180 days of each other. From medical record review, we compared frequencies of each finding between modalities. Of the 1274 patients who received a baseline TVS over 2 years, 327 had TVS and HSG within 180 days and 55 patients had TVS, HSG and HSC. Of the 327, TVS detected fibroids more often than HSG (74 vs. 5,

CONCLUSIONS: TVS is superior for evaluation of myometrial pathology. HSG is superior for evaluation of tubal pathologies. Endometrial pathologies are best identified with HSC.

Keywords: Hysterosalpingography; Infertility; Transvaginal sonography

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