Methods of testing patency of Fallopian Tube.

For checking tubal patency HSG or SSG? Which gives accurate results? What is your practice??

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A)HSG:--HSG is a better option, available almost all small towns, and still commonly practiced method. But the drawbacks of HSG are:-HSG is 1) very painful and 2) awkward procedure being done at X-ray Deptt-?? (presence of male staff of Radiologist Deptt , minimum privacy)  and 3) lead to sometimes false positive results ultimately requiring diag hysteroscopy at a later date due to inconclusive information obtained from  earlier HSG. 4) Cavitary disorders are not easily delineated in comparison to SSG   5) but cant point of site of block in tube.

B)  . But the advantages are that HSG is economical but in working up a case of infertility in an elderly woman laparoscopy would be better –more so if there is clinically suggestive of minimal endometriosis or peel adhesive diseases  or those women who  had  H/O some pelvic surgery.

Some say that laparoscopy is a better option because in HSG false positive is high.

C)  SSG :- SSG  is operator biased but SSG also rules out uterine anomalies.SSG therefore has the dual advantage of Tubal patency & detecting  ut abnormalities, Cavitary disorders in particular, adv of SSG, less pain & above all no radiation. But if one intends to evaluate the tubes only then HSG will suffice Disadv of SSG:-matricidal illusions on screen
operator dependent, regarding monetary point both are equally expensive.

There is a rising trend of infertility specialists to suggest Single puncture laparoscpy to have maximum informations.

 

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