Evaluation of tubal patency in infertile patients with saline infusion sonosalpingogram

Background: The incidence of tubal disease in infertility in India is as high as 40%. The aim of our study is to evaluate the diagnostic accuracy of Saline Infusion Sonosalpingogram (SSG) in the assessment of tubal patency in infertile patients with laparoscopy as the gold standard.Methods: This is a prospective study conducted in the department of obstetrics and gynaecology on 50 consecutive infertile patients. Patients with acute pelvic inflammatory disease were excluded from the study. After complete examination and basic infertility work up, the tubal patency testing by Saline Infusion Sonosalpingogram was performed on day 8 of the cycle, followed by diagnostic laparoscopy with chromopertubation to confirm the tubal patency.Results: Out of 50 enrolled patients, 3 were excluded during the course of study. Thus, the study population comprised of 47 infertile women. During our study, 42 patients had tubes patent on SSG, out of which 41 patients had patent tubes on laparoscopy. 2 patients with blocked tubes on SSG had patent tubes on laparoscopy. 3 patients had blocked tubes on both SSG and laparoscopy. On statistical analysis, the sensitivity of SSG in diagnosing tubal patency is 95.34%, specificity 75%, positive predictive value 97.65% and negative predictive value 60%.Conclusions: Saline Infusion Sonosalpingogram is a simple, safe, convenient procedure for assessment of tubal patency in infertile women. It can be included in basic infertility work up. Hence, laparoscopy can be reserved for patients with tubal block, suspected pelvic pathology and unexplained infertility