Role of Saline Hysterosalpingography (SIS-HSG) in Assessing Tubal Patency: A Less Invasive Alternative to Conventional HSG
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Abstract
Background: Tubal factor infertility accounts for approximately 25–35% of infertility cases, necessitating accurate diagnostic methods. Conventional HSG, though widely used, is associated with discomfort and radiation exposure. SIS-HSG provides a safer, radiation-free alternative with real-time imaging. Objective: This study aimed to assess the efficacy, safety, and diagnostic accuracy of SIS-HSG compared to conventional HSG in evaluating tubal patency among infertile women in Bangladesh. Methods: A prospective comparative study was conducted at Islami Bank Medical College, Rajshahi, and Popular Diagnostic Center, Rajshahi, Bangladesh, from January 2023 to December 2024. A total of 132 women with suspected tubal factor infertility underwent both SIS-HSG and conventional HSG. Tubal patency, procedural discomfort, complications, and diagnostic concordance were analyzed using statistical methods, including standard deviation (SD) and p-values. Results: SIS-HSG demonstrated a tubal patency detection rate of 92.4%, comparable to conventional HSG at 94.7% (p = 0.34). The sensitivity and specificity of SIS-HSG were 91.2% and 95.5%, respectively, with a diagnostic accuracy of 93.3%. The mean procedural pain score for SIS-HSG was significantly lower (3.1 ± 1.2) compared to HSG (5.7 ± 1.5) (p < 0.001). The rate of adverse reactions was reduced in SIS-HSG (3.8%) compared to HSG (12.1%) (p = 0.015). Standard deviation for procedural duration in SIS-HSG was 2.4 minutes, significantly shorter than HSG (SD = 4.1 minutes) (p = 0.002). Conclusion: SIS-HSG offers a reliable, less painful, and radiation-free alternative for tubal patency assessment. Its high diagnostic accuracy and improved patient tolerance advocate for its integration into routine infertility diagnostics.
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Barrera N, Omolaoye TS, Du Plessis SS. A contemporary view on global fertility, infertility, and assisted reproductive techniques. InFertility, Pregnancy, and Wellness 2022 Jan 1 (pp. 93-120). Elsevier.
Thaker N, Dhande R, Parihar P, DHANDE R. Role of transvaginal sonography in the diagnosis of female infertility: A comprehensive review. Cureus. 2023 Dec 6;15(12).
Ambildhuke K, Pajai S, Chimegave A, Mundhada R, Kabra P. A review of tubal factors affecting fertility and its management. Cureus. 2022 Nov 1;14(11).
Török P, Molnár S, Herman T, Jashanjeet S, Lampé R, Riemma G, Vitale SG. Fallopian tubal obstruction is associated with increased pain experienced during office hysteroscopy: A retrospective study. Updates in surgery. 2020 Mar;72:213-8.
Elsayed L, Elfawal M, Abdou AM, Alsowey AM. Sonohysterography versus hystroscopy in evaluation of uterine cavity pathology. Zagazig University Medical Journal. 2022 Mar 1;28(2):284-96.
Hou JH, Lu BJ, Huang YL, Chen CH, Chen CH. Outpatient hysteroscopy impact on subsequent assisted reproductive technology: a systematic review and meta-analysis in patients with normal transvaginal sonography or hysterosalpingography images. Reproductive Biology and Endocrinology. 2024 Feb 1;22(1):18.
Borna, N. A., Khatun, M. M., Lina, K. S. N., & Khatun, W. (2024). Role of Minimally Invasive Surgery in Managing Ovarian Cysts: A Study of Postoperative Recovery. IAR Journal of Medicine and Surgery Research, 5(5), 32-40.
Bennett A. Meeting of the British Medical Ultrasound Society, 6–8 December 2022, City Hall, Cardiff, UK. Ultrasound. 2023;31:2.
Kumar K, Pajai S, Baidya GR, Majhi K. Utility of saline infusion sonohysterography in gynecology: a review article. Cureus. 2023 Feb 24;15(2).
Chiu TM, Chu SY. Hypersensitivity reactions to iodinated contrast media. Biomedicines. 2022 Apr 30;10(5):1036.
Yoon I, Slesinger TL. Radiation exposure in pregnancy. InStatPearls [Internet] 2023 May 1. StatPearls Publishing.
Nguyen E, Strug M, Gardner A, Burney R, Campbell S, Aghajanova L. Initial fertility evaluation with saline sonography vs. hysterosalpingography: it is debate-tubal. Fertility and Sterility. 2024 Jun 1;121(6):922-30.
Özokçu E, Aker SŞ, Ağar E, Berker B. The role of saline infusion sonohysterography in the evaluation of infertility. Anatolian Current Medical Journal. 2023;5(3):201-5.
Fallara G, Cazzaniga W, Boeri L, Capogrosso P, Candela L, Pozzi E, Belladelli F, Schifano N, Ventimiglia E, Abbate C, Papaleo E. Male factor infertility trends throughout the last 10 years: report from a tertiary‐referral academic andrology centre. Andrology. 2021 Mar;9(2):610-7.
Akter J, Rahman F. Study of Saline Infusion Sonography and Hysterosalpingography to See the Tubal Patency in the Infertile Women. Journal of Comilla Medical College Teachers' Association. 2023 Oct 31;27(1):27-33.
Tiwari A, Singh BK, Mishra A. A comparative study to evaluate diagnostic accuracy and correlation between saline infusion sonography, hysterosalpingography and diagnostic hysterolaparoscopy in infertility. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2020 Jan 28;9(2):669.
Maxim AR, Gligor OH, Badea RI. Comparison of hystero-salpingography and hysterosalpingo-contrast sonography for tubal patency testing: technical success, pain perception, side effects and complications. Medical Ultrasonography. 2021 Aug 11;23(3):283-8.
Moustafa S, Rosen E, Goodman L. Patient and provider satisfaction with saline ultrasound versus office hysteroscopy for uterine cavity evaluation prior to in vitro fertilization: a randomized controlled trial. Journal of Assisted Reproduction and Genetics. 2021 Mar;38:627-34.
Margules AC, Rovner ES. Urinary Tract Fistula. Urologic Principles and Practice. 2020:517-38.
Özel MK, turan Çetin M. Surgical Treatment Options for Female Infertility. Duzce Medical Journal. 2022 May 2;24(Special Issue):68-77.
Mathews DM, Peart JM, Sim RG. medium hysterosalpingography: a prospective cohort study. Endocrine and Metabolic Effects on Maternal-fetal and Neonatal Outcomes, Volume II. 2024 Sep 20:82.
Tsui S, Sofy AA. A meta-analysis of fertility and adverse outcomes in oil-and water-based contrast for hysterosalpingography. Turkish Journal of Obstetrics and Gynecology. 2023 Mar 10;20(1):64.
Bhattacharya R, Ramesh AC. A comparative study of saline infusion sonohysterography and hysterosalpingography for evaluation of female infertility. Int J Reprod Contracept Obstet Gynecol. 2020 Jan 1;9(1):179-83.
Igbodike EP, Badejoko OO, Fasubaa OB, Ibitoye BO, Loto OM, Ikechebelu JI, Eleje GU, Onwuegbuna AA, Okpala BC, Umeononihu OS, Ogelle OM. Correlation between hysterosalpingography diagnosis and final hysterolaparoscopy with dye-test diagnosis in women with utero-tubal infertility: A cross-sectional study of the implication for which test should be the first-line investigation. SAGE Open Medicine. 2022 Jun;10:20503121221104434.
Patwari SQ. Transforming Rural Health: The Impact of Telehealth on Access and Care. TAJ: Journal of Teachers Association. 2021 Dec 31;34(2):51-56.
Ahasan MM, Patwari MS, Yamaguchi M. Risk of eating disorders and the relationship with interest in modern culture among young female students in a university in Bangladesh: a cross-sectional study. BMC Women's Health. 2023;23(1):35.
Patwari SQ. Public Health during the Global Pandemic Covid-19: Intervening, Perceiving and Incorporating.
Hasan H, Rahman MH, Haque MA, Rahman MS, Ali MS, Sultana S. Nutritional management in patients with chronic kidney disease: A focus on renal diet. Asia Pacific Journal of Medical Innovations. 2024 ;1(1):34-40.
Patwari SQ. Rise of E-Cigarettes: Implications for Public Health and Policy. TAJ: Journal of Teachers Association. 2017 Dec 31;30(2):43-51.
Mashiusjaman M, Patwari SQ, Siddique MA, Haider SM. Infant feeding pattern of employed mothers in Dhaka city of Bangladesh.
Patwari SQ. Bridging the Gap: Impact of Race, Gender, and Socioeconomic Factors on Health Equity. TAJ: Journal of Teachers Association. 2015 Dec 31;28(2):51-58.
Najjar R. Clinical applications, safety profiles, and future developments of contrast agents in modern radiology: A comprehensive review. iRADIOLOGY. 2024 Oct;2(5):430-68.