Comparison Of Transvaginal Saline Infusion Sonohysterography And Hysterosalpingography In Detecting Uterine And Tubal Pathologies Among Women Undergoing Infertility Evaluation

Abstract

Objective: The Study Aimed To Evaluate The Reliability Of Transvaginal Saline Infusion Sonohysterography (SIS) Versus Hysterosalpingography (HSG) For Detecting Uterine And Tubal Abnormalities During Infertility Evaluation And To Propose A Diagnostic Algorithm Integrating SIS. We Hypothesized That SIS Would Serve As A Reliable Alternative To HSG In Selected Cases. Methods: In This Prospective Cross-Sectional Study, 125 Women Underwent Both SIS And HSG. Findings Were Compared Using Kappa Statistics And Sensitivity/Specificity Analyses; Data Were Analyzed With IBM SPSS Statistics V20. Sample Characteristics Are Reported As Mean ± SD And Proportions. HSG Served As The Pragmatic Reference Standard. Results: Participants Were Aged 20–45 Years (Mean 34.2 ± 5.02); 80% Had Secondary Infertility. Uterine Synechiae And Bilateral Tubal Occlusion Were The Most Frequent Uterine And Tubal Findings, Respectively. Kappa Analysis Showed High Concordance For Normal Uterine Morphology (Ƙ = 0.86). For Identifying A Normal Uterine Morphology, SIS Sensitivity Was 93.6%, Specificity 96.8%, PPV 98.9%, And NPV 83.3%. SIS Achieved 100% Sensitivity For Intramural/Submucous Fibroids And Endometrial Polyps Compared With HSG. Agreement For Bilateral Patent Tubes And Bilateral Tubal Blockage Was Strong (K=0.83 And K=0.85, Respectively) Conclusion: SIS Is A Safe, Cost-Effective, Well-Tolerated And Reliable Technique With Excellent Diagnostic Performance For Uterine And Endometrial Pathology And Comparable Tubal Assessment. SIS May Serve As A First-Line Diagnostic Tool For Infertility Evaluation, Particularly In Resource-Limited Settings