Saline Infused Sono-Hysterosalpingography; A Step Forward in the Diagnosis of Infertility Due to Tubal Blockage

Background: Saline infused Sono hysterosalpingography (SSG) is the new and safe modality as compared to conventional hysterosalpingogrphy (HSG) for diagnosis of tubal blockage. Objective: To determine the diagnostic accuracy of saline infused Sono hysterosalpingohgraphy, for detection of fallopian tube blockage, in cases with infertility taking conventional hysterosalpingography as gold standard. Methodology: This was a cross sectional study conducted in Department of Radiology, Sheikh Zayed Hospital, Rahim Yar Khan, conducted from May to November, 2017. A total of 150 cases, with age range of 20-40 years, irrespective of type and duration of infertility, were included. Findings of tubal blockage with saline infused Sono hysterosalpingography (SSG), were compared to conventional hysterosalpingogrphy (HSG). Sensitivity, Specificity, PPV, NPV and Diagnostic accuracy of saline infused Sono-hysterosalpingography, for detection of fallopian tube blockage, in cases with infertility were calculated, taking conventional hysterosalpingography as gold standard. Results:  A total of 150 cases were examined, with mean age 32±5 years and mean duration of infertility was 3.51±1.86 years. Overall, 99 (66%) cases had primary infertility. Tubal obstruction was seen in 92 (61.33%) cases on HSG and 90 (60%) on SSG. The sensitivity of SSG for tubal obstruction was 77.14%, PPV 78.89% and diagnostic accuracy 75.33% with p= 0.001. The specificity and PPV was 100% in cases with age 30-40 years with p= 0.001. The diagnostic accuracy in multiparous women was 81.82. (p=0.001) Conclusion:  Saline infused sono hysterosalpingography revealed high sensitivity, specificity, PPV, NPV and diagnostic accuracy, which were comparable with conventional hysterosalpingography.