P-249: Concordance Rate of Hystrosalpingography and Laparoscopy in Diagnosis of Tubo-Pritoneal Pathology in Infertile Women

Background: Infertility is defined as 1 year of unprotected intercourse without pregnancy. The main causes of infertility are as follows: male factor, Both mail and female, as well as unexplained etiologies. Tubal and peritoneal factors Aceount for 30%-40% of causes of female infertility. Tubal factors include damage and obstraction of the fallopian tube, usually associated with previous pelvic inflamatory disease (PID) or previous pelvic or tubal surgery. Pritoneal factors include peritoneal adhisions which generally results from PID or surgery and endometirosis. Hystrosalpingography (HSG) is the initial test of tubal patency and the gold standard for diagnosis of tubal and pritoneal disease is laparascopy. Concordance of H.S.G with laparascopy is 2/3 in a lot of refrences and concordance of two procedures was reported poor in this center in 1998. To find the better results, this study is conducted on more cases. Materials and Methods: In this study, the records of H.S.G and laparascopy of 200 infertile patients was assessed from 2011 to 2012, then sensivity, specifity, positive and negative predictive value and concordance of two procedures were calculated. Results: In this study, sensitivity and specificity of HSG in tubal obstraction are 60, 81% respectively, and positive - and negative predictive value are 43, 89% respectively and concordance with laparascopy is 36%. Sensivity and specificity of HSG in hydrosalpinx are 23, 95% respectively, and positive and negative predictive values are 61, 80% respectively. Concordance with laparascopy is 23%. Sensitivity and specificity of HSG in peritoneal adhisions, endometriosis and delayed spillage are 37, 79% respectively, Positive and negative predictive value are 51, 67% respectively. Concordance with laparascopy is 17%. Conclusion: With evaluation of the results, it seems that H.S.G is not the accurate procedure for diagnosis of tubo-pritoneal pathology, but because the laparascopy is an invasive procedure, a more accurate study is recommended for better results.