IS HYSTEROSALPINGOGRAPHY AN IMPORTANT TOOL IN PREDICTING FERTILITY OUTCOME

Objective: To determine the prognostic significance of hysterosalpingo graphy (HSG) for fertility outcome. Design: Retrospective cohort study . Setting: Infertility department of an academic hospital. Patient(s): Consecutive patients undergoing HSG for subfertility between May 1985 and November 1987. Intervention(s): Hysterosalpingography. Main Outco me Measure(s): Follow-up ended when pregnancy or tubal surgery occurre d or at the day of last contact. Kaplan-Meier curves for the occurrenc e of spontaneous intrauterine pregnancy (IUP) were constructed for a n ormal HSG, a HSG with a one-sided abnormality, and a HSG with a two-si ded abnormality. Fecundity rate ratios were calculated to express the association between HSG findings and the occurrence of spontaneous IUP . Result(s): Of 359 patients that were analyzed, 231 (64%) showed no t ubal pathology on HSG, 67 (19%) had a one-sided tubal pathology, and 6 1 (17%) had a two-sided tubal pathology. The adjusted fecundity rate r atios were 0.81 (95% confidence interval 0.47 to 1.4) for a one-sided pathology and 0.30 (95% confidence interval 0.13 to 0.71) for a two-si ded pathology. Correction for informative censoring and sensitivity an alysis did not alter these results. Conclusion(s): One-sided tubal pat hology detected on HSG has limited prognostic significance, whereas tw o-sided tubal pathology detected on HSG reduces fertility prospects co nsiderably. (C) 1997 by American Society for Reproductive Medicine.