Air-contrast sonohysterography as a first step assessment of tubal patency

We assessed the use of air as a sonographic contrast agent in the investiga tion of tubal patency by sono-hysterography. We examined 115 women assessed for infertility. After saline sonohysterography, small amounts of air were insufflated, and the tubal passage of bubbles was monitored. In five patie nts (excluded from the results), cervical stenosis prevented the procedure. Ninety-one tubes (right side) and 86 tubes (left side) were definitively p atent; 5 and 7, respectively, were probably patent; and 12 and 16, respecti vely, were nonvisualized. Nine patients had polyps, 3 had synechiae, and 2 had submucosal fibroids. None of the patients had infectious complications. Air-sonohysteroaraphy and laparoscopy with chromopertubation show agreemen t in 79.4%. In 17.2% of patients, the tubes were considered nonvisualized b y air-sonohysterography when they were patent. The sensitivity was 85.7% an d specificity 77.2%. In conclusion, air sonohysterography is a comfortable, simple, and inexpensive first line of tubal patency investigations yieldin g high accuracy.