Comparative Evaluation of Saline Infusion Sonohysterography and Hysterolaparoscopy

Tuboperitoneal factors are responsible for about 30 to 40% of female infertility. The incidence of tubal disease in infertility varies from country to country. In India it has been estimated to be about 40%.1 The prevalence of pelvic inflammatory disease and genital tract tuberculosis are common in our country and hence the incidence of tubal factor in infertile women is high.2 There are various methods available for evaluation of uterine cavity and tubal patency. The widely employed methods are hysterosalpingography (HSG) and hysterolaparoscopy with CPT. Saline infusion sonohysterography (SIS) is being widely used for evaluation of uterine cavity as well as tubal patency.2 Every method has its own merits and demerits. HSG is an invasive technique associated with pelvic infection, pain and risk of radiation exposure.3 Small polyps cannot be picked up by HSG. Laparoscopy is also an invasive and expensive procedure. It also carries the risk of anesthetic complications.4 In many cases of infertility hysterolaparoscopy will be normal. Hence is a need for a screening test like SIS. Saline infusion sonohysterography is a simple, safe and minimal invasive procedure unlike hysterolaparoscopy.5 SIS is also free from the risk of radiation exposure unlike HSG. The present study was done to compare the diagnostic accuracy of SIS with hysterolaparoscopy and CPT for evaluation of the uterine cavity and tubal patency.