RADIONUCLIDE HYSTEROSALPINGOGRAPHY IS NOT PREDICTIVE IN THE DIAGNOSISOF INFERTILITY

Objective: To investigate whether radionuclide hysterosalpingography ( radionuclide HSG), which has been suggested as a more functional appro ach to the diagnosis of tubal infertility than conventional patency te sts, is predictive in the diagnosis of infertility: Design: A retrospe ctive analysis of data from an inquiry form containing questions about pregnancy outcome after radionuclide HSG. Setting: University hospita l-based, tertiary care infertility clinic. Patient(s): Two hundred six teen women had an infertility work-up including radionuclide HSG perfo rmed between April 1986 and April 1993. Forty-one (18.9%) women were e xcluded from the study; 9 had moved to unknown addresses, 16 did not a nswer the inquiry, and 16 gave answers that were not interpretable. Th ere were 175 (81.1%) women in the final study group. Intervention(s): An inquiry form containing questions regarding pregnancy was sent to 2 07 women who had undergone radionuclide HSG as a routine procedure in their infertility workup. Main Outcome Measure(s): Occurrence of pregn ancy related to outcome of radionuclide HSG and its test properties ca lculated. Result(s): Bilateral or unilateral tubal transport was demon strated by radionuclide HSG in 129 women, of whom 66 (51%) later becam e pregnant. Of the pregnant women, 36 (55%) had successful infertility treatment, whereas 30 (45%) reported spontaneous pregnancy. Forty-six women showed no transport at radionuclide HSG. Twenty-five (54%) of t hese women became pregnant, 14 (56%) with infertility treatment and 11 (44%) without infertility treatment. The predictive values of transpo rt and no transport radionuclide HSG were 0.51 and 0.46, respectively. The sensitivity of radionuclide HSG was 0.25, and the sensitivity was 0.73; Likelihood ratios for pregnancy when radionuclide HSG showed tr ansport and no transport were 1.03 and 0.93, respectively. Conclusion( s): Our data strongly indicate that a single radionuclide HSG investig ation is not able to predict fertility potential. (C) 1998 by American Society for Reproductive Medicine.