Portuondo J A, Peña Irala J, Ibañez E, Echanojuaregui A D
Int J Fertil. 1984;29(2):85-90.
For a period of time routine hysterosalpingography and laparoscopy were carried out in every patient complaining of more than 2 years of primary infertility. The records of 433 such patients were retrospectively evaluated according to their clinical aspects. Complete agreement between the two diagnostic methods was found in 70.9% of this unselected population. Almost 50% of the population had some abnormalities in either hysterosalpingography or laparoscopy. According to the patient's past history, pelvic examination, and the duration of infertility, the unselected infertile population was classified into a) high risk infertility and b) low risk infertility. High risk infertility patients had (P less than 0.01) greater abnormal findings at both hysterosalpingography and laparoscopy. In this high risk group we recommend early laparoscopy and the postponement of hysterosalpingographic investigation for patients with suspected cornual occlusion or destruction of ampullary rugae (valuable in assessing tubal damage). Low risk infertility patients had (P less than 0.01) low abnormal findings at both hysterosalpingography and laparoscopy, and in these patients hysterosalpingography does not discriminate the group of higher abnormal laparoscopic findings. Hysterosalpingography can be initially indicated as a less invasive investigation in the low risk group. We conclude that clinical data are very valuable in the selection of infertile patients for early or late laparoscopy.
在一段时间内，对每一位主诉原发性不孕超过2年的患者都进行了常规子宫输卵管造影和腹腔镜检查。根据临床情况，对433例此类患者的记录进行了回顾性评估。在这个未经过筛选的人群中，两种诊断方法完全一致的情况占70.9%。几乎50%的人群在子宫输卵管造影或腹腔镜检查中存在一些异常。根据患者的既往病史、盆腔检查和不孕持续时间，将未经过筛选的不孕人群分为a）高风险不孕和b）低风险不孕。高风险不孕患者在子宫输卵管造影和腹腔镜检查中出现异常结果的比例更高（P<0.01）。在这个高风险组中，对于怀疑有子宫角阻塞或壶腹部皱襞破坏的患者（对评估输卵管损伤有价值），我们建议早期进行腹腔镜检查，并推迟子宫输卵管造影检查。低风险不孕患者在子宫输卵管造影和腹腔镜检查中出现异常结果的比例较低（P<0.01），在这些患者中，子宫输卵管造影无法区分腹腔镜检查中异常结果较高的那一组。子宫输卵管造影最初可作为低风险组中侵入性较小的检查方法。我们得出结论，临床数据对于选择不孕患者进行早期或晚期腹腔镜检查非常有价值。
