Uterotubal Insufflation and Hysterosalpinography

Although during the past twenty-five years insufflation and hysterosalpingography have both become established and widely practised procedures in the investigation of sterility, there are still certain aspects of both techniques upon which full agreement has not been reached. One of these is the question whether they should be regarded as alternative rather than as complementary procedures, another the determination of their true therapeutic as opposed to their undoubted diagnostic value. There is, too, an even more pressing need to integrate both procedures with the newer methods now available for the investigation of sterility. In the preparation of the present paper much help has been derived from the recent paper by Sharman (I944), particularly with regard to the technique and results of insufflation, and the papers by Witwer, Bushman and Leucutia (I930), and Green-Armytage (1943) dealing with hysterosalpingography. In order to provide a personal standard of reference a special re-examination and follow-up was undertaken of cases investigated in the five years preceding the war. This period was chosen in order to allow a reasonable time for the end results to be apparent, and also to avoid the complications introduced by the war. In so complex a problem as sterility it is desirable to deal with the most stable population possible.