HYSTERO-SALPINGO SCINTIGRAPHY - A ROUTINE INVESTIGATION IN STERILE WOMEN

Based on the spontaneous migration of radioactive tracer from the post erior vaginal fornix to the ovaries and peritoneal cavity, several att empts were made to assess hystero-salpingo scintigraphy (HSS). The low acceptance rate by sterile women of routine investigation of tubal fu nction may be due to a fear of radiation exposure and unpleasant exami nation procedures. Our protocol for HSS adopts a low dose of radioacti ve tracer (0.2-0.3 mCi), a defined mode of application (between the ex ternal and internal os of the cervical canal) and a short imaging time (60 min). From 1990 to 1992, we investigated 60 fallopian tubes in 32 sterile women by HSS, hystero-salpingography (HSG) and/or chromopertu bation during laparoscopy (LPSC). The results of HSG and HSS correspon ded in 15 of 49 fallopian tubes, LPSC and HSS in 9 of 24. None of the 32 patients had become pregnant naturally during the average observati on period of 17 months. Two patients became pregnant after in-vitro fe rtilization. HSS, performed according to our protocol, causes less pai n and results in a lower dose of radiation than HSG (about 50%). It is well accepted by patients and is easy to perform. As an investigation of tubal function, HSS may serve as an additional examination techniq ue in cases of presumed tubal sterility.