Sonohysterography and Sonohysterosalpingography: Excellent Contenders in Israel for Cavity and Tubal Assessment

Introduction:

Fallopian tube and uterine cavity pathologies are significant contributors to infertility. Their investigation may be accomplished via different imaging modalities. Sonohysterographic imaging may be emerging as a superior contender.

Aim:

Sonohysterography or sonohysterosalpingography was performed between November 2014 and February 2017 at Shaare Zedek Medical Center. Patients were either referred internally or from outside physicians for uterine cavity and/or fallopian tube patency assessment. This was accomplished by combining the use of intrauterine balloon catheter, saline or air-saline interfaces, and 3-dimensional ultrasound. ‪

Results:

A total of 231 exams were performed. Of those presenting for infertility assessments, the median time of infertility was 1 to 2 years (n=137). 205 examinations had clearly noted indications: 5.9% (12/205) for suspected fallopian tube blockage, 9.8% (20/205) for suspected endometrial polyp, 2.9% (6/205) for suspected other uterine cavity abnormalities, and 22.4% (46/205) for routine assessment prior to assisted reproductive technology (ART). Cavity pathology or variations were noted in 26.8% (62/231) of patients. Of the 164 that underwent assessment for fallopian tube patency, bilateral tubal blockage, unilateral blockage, and hydrosalpinx were noted in 6.7% (n=11), 9.8% (n=16), and 1.2%(n=2) respectively. Of those with patency in at least 1 tube (n=152), fluid was noted in the cul-de-sac in 88.9% (135/152).

Conclusion:

Sonohystero and salpingographic imaging are excellent diagnostic contenders for fertility-related evaluation of the uterine cavity and fallopian tubes.

Photos and videos of the examination will also be included, as well as some special cases (e.g. endometrial polyps that were not diagnosed by hysteroscopies, and more).