Singh Vinita, Mishra Byasdev, Sinha Snehil, Agrawal Sarita, Thakur Pushpawati
Department of Obstetrics and Gynaecology, AIIMS, Raipur, Chhattisgarh, India.
J Hum Reprod Sci. 2018 Jul-Sep;11(3):236-241. doi: 10.4103/jhrs.JHRS_47_18.
Etiology of infertility is multifactorial, and fallopian tube abnormality being one of the most important causes accounts for up to 40% of female subfertility if not less and is further increasing. Saline infusion sonohysterography (SIS) procedure is gaining popularity and is being widely practiced and accepted as a screening tool in assessing tubal patency in infertile patients attending infertility clinic and has become popular as a routine test for the evaluation of the uterine cavity in the investigation of infertility and abnormal uterine bleeding.
To compare the results of SIS with that of hysterosalpingography in infertility evaluation and to observe the role of SIS to find out endometrial pathology and tubal patency in infertility patients.
A retrospective, observational study was done on the basis of record maintained in the ultrasound register and case record sheets of all infertile women who underwent infertility treatment and fulfilled the inclusion criteria from June 2015 to August 2016.
SIS had sensitivity of 91%, specificity of 76% positive predictive value (PPV) of 95%, negative predictive value (NPV) of 66%, and accuracy of 89% of SIS in evaluating tubal patency. Further, SIS showed sensitivity of 83.3%, specificity of 60%, PPV of 75%, NPV of 75%, and accuracy of 72% in detecting pelvic pathology.
In a low-resource country like India where patients are also less educated, SIS can prove to be a useful tool in initial workup of infertility patients with better compliance, low cost, and better results in a single visit.
不孕症的病因是多因素的，输卵管异常是最重要的原因之一，占女性生育力低下的比例高达40% 甚至更多，且呈进一步上升趋势。生理盐水灌注子宫输卵管超声造影（SIS）检查正日益普及，在不孕症门诊评估不孕患者输卵管通畅性时作为一种筛查工具被广泛应用和接受，并且作为不孕症及子宫异常出血检查中评估子宫腔的常规检查也很受欢迎。
比较SIS与子宫输卵管造影在不孕症评估中的结果，并观察SIS在不孕症患者中发现子宫内膜病变及输卵管通畅性方面的作用。
基于2015年6月至2016年8月期间接受不孕症治疗且符合纳入标准的所有不孕女性的超声登记记录及病历单进行了一项回顾性观察研究。
SIS评估输卵管通畅性的敏感度为91%，特异度为76%，阳性预测值（PPV）为95%，阴性预测值（NPV）为66%，准确率为89%。此外，SIS在检测盆腔病变方面的敏感度为83.3%，特异度为60%，PPV为75%，NPV为75%，准确率为72%。
在像印度这样资源匮乏且患者受教育程度也较低的国家，SIS在不孕症患者的初始检查中可被证明是一种有用的工具，具有更好的依从性、低成本且单次就诊就能获得更好的结果。
