Luciano Danielle E, Exacoustos Caterina, Luciano Anthony A
Center for Fertility and Women's Health, Department of Gynecology, New Britain, Connecticut.
Center for Fertility and Women's Health, Department of Gynecology, New Britain, Connecticut.
J Minim Invasive Gynecol. 2014 Nov-Dec;21(6):994-8. doi: 10.1016/j.jmig.2014.05.017. Epub 2014 Jun 6.
Evaluation of tubal patency is an essential part of a fertility workup. Laparoscopy with chromopertubation in conjunction with hysteroscopy is the gold standard in evaluation of tubal patency and the uterine cavity. In this review article we describe a newer method for evaluation of the uterus and fallopian tubes, that is, hysterosalpingo-contrast sonography (HyCoSy). Accuracy of HyCoSy for tubal patency has been shown to be comparable to that with hysterosalpingography (HSG) when compared with laparoscopic chromopertubation. Sensitivity ranges from 75% to 96%, and specificity from 67% to 100%. HyCoSy is also accurate when compared with HSG in determining tubal occlusion after hysteroscopic sterilization, with 88% of patients stating they would prefer to undergo the tubal occlusion test in their gynecologist's office. Because HyCoSy also includes evaluation of the uterine cavity with saline solution-enhanced sonohysterography, accuracy in evaluating the uterine cavity is >90% when compared with hysteroscopy. HyCoSy enables the gynecologist to complete a fertility workup in the office in the most minimally invasive way. HyCoSy is well tolerated and has been suggested in the literature to replace HSG for evaluation of tubal disease in the subfertile population.
输卵管通畅性评估是生育力检查的重要组成部分。腹腔镜下输卵管通液术联合宫腔镜检查是评估输卵管通畅性和子宫腔的金标准。在这篇综述文章中，我们描述了一种评估子宫和输卵管的新方法，即子宫输卵管造影超声检查（HyCoSy）。与腹腔镜下输卵管通液术相比，HyCoSy评估输卵管通畅性的准确性已被证明与子宫输卵管造影（HSG）相当。敏感性范围为75%至96%，特异性为67%至100%。在宫腔镜绝育术后确定输卵管阻塞方面，与HSG相比，HyCoSy也具有准确性，88%的患者表示他们更愿意在妇科医生办公室接受输卵管阻塞检查。由于HyCoSy还包括用生理盐水增强超声子宫造影评估子宫腔，与宫腔镜检查相比，评估子宫腔的准确性>90%。HyCoSy使妇科医生能够以最微创的方式在办公室完成生育力检查。HyCoSy耐受性良好，文献中已建议用其替代HSG来评估亚生育人群的输卵管疾病。
