PREGNANCY RATE FOLLOWING NORMAL VERSUS ABNORMAL HYSTEROSALPINGOGRAPHYFINDINGS - A METAANALYSIS

A computerized Medline search was conducted, to assess the prognostic value of hysterosalpingography (HSG) and the probability of pregnancy after normal versus abnormal HSG findings. A total of 13 studies turne d out to be eligible, reporting on 3,277 women. 15% of women with an a bnormal HSG and 32% of women with a normal HSG achieved pregnancy. Sen sitivities and specificities of the studies were heterogeneous. The po oled odds ratio was 3 (95% CI: 2.3-3.4). Its ROC Curve shows that, at the operating point yielding the lowest number of misclassifications, a sensitivity of 63% and a specificity of 62% is achieved. Seven studi es reported unilateral and bilateral obstruction. Odds ratios were 2 ( 95% CI: 1.5-2.6) and 19 (95% CI: 7.5-46.5) respectively. So, overall, HSG has a low prognostic value, the outcome of HSG adds little to pred icting the occurrence of pregnancy. However, when HSG shows bilateral obstruction, the chance of getting pregnant is only minimal.