THE ROLE OF HYSTEROSALPINGOGRAPHY IN THE EVALUATION OF INFERTILITY

Hysterosalpingography is the only radiologic procedure routinely perfo rmed in the initial evaluation of the infertile woman. Hysterosalpingo graphy is used to assess the anatomy of the uterus and the patency of the fallopian tubes, and is performed in the proliferative phase of th e menstrual cycle. It can be performed with either water- or oil-solub le contrast medium. Care should be taken during the procedure that exc essive amounts of contrast medium are not injected, because that could obscure the diagnostic findings. Selective salpinogography can help e valuate a suspected proximal tubal occlusion. The complications associ ated with hysterosalpingography include pain, pelvic infection, intrav asation of contrast medium and allergic reactions. Abnormal hysterosal pingographic findings include occlusion of one or both fallopian tubes , uterine filling defects and mullerian anomalies. Therapy for abnorma l hysterosalpingographic findings depends on the specific clinical sce nario and includes endoscopic surgery, laparotomy and in vitro fertili zation.