Ultrasonography reappraisal of tubal patency in ART patients: comparison between 2D and 3D Sonohysterosalpingography. A pilot study.
Cesare Aragona (IT), Lucia Riganelli (IT), Jlenia Caccetta (IT), Lucia Merlino (IT), Marianna Mariani (IT), Silvia Franceschetti (IT), Alessandro Ruffa (IT), Alessia Aragona (IT), Oriana Capri (IT), Daniela Pietrangeli (IT), Maria Grazia Piccioni (IT)
[Aragona] Department of Gynecological and Obstetric Sciences and Urological Sciences, Sterility and Assisted Reproduction Unit, Policlinico Umberto I Rome, University of Rome "Sapienza", Rome, Italy, [Riganelli] Department of Gynecological and Obstetric Sciences and Urological Sciences, Sterility and Assisted Reproduction Unit, Policlinico Umberto I Rome, University of Rome "Sapienza", Rome, Italy, [Caccetta] Department of Gynecological and Obstetric Sciences and Urological Sciences, Sterility and Assisted Reproduction Unit, Policlinico Umberto I Rome, University of Rome "Sapienza", Rome, Italy, [Merlino] Department of Gynecological and Obstetric Sciences and Urological Sciences, Sterility and Assisted Reproduction Unit, Policlinico Umberto I Rome, University of Rome "Sapienza", Rome, Italy, [Mariani] Department of Gynecological and Obstetric Sciences and Urological Sciences, Sterility and Assisted Reproduction Unit, Policlinico Umberto I Rome, University of Rome "Sapienza", Rome, Italy, [Franceschetti] Depar
Objective: The aim of our study was to compare 2D vs 3D Sono-HSG in the diagnosis of tubal patency in ART (Assisted Reproduction Technology) patients with previous laparoscopy. Methods: we prospectively enrolled ART infertile women, previously elsewhere submitted to laparoscopy and randomly allocated into 2D-HyFoSy (Sonohysterosalpingography with foam) (group I) and 3D-HyFoSy (group II). We analyzed the results in terms of sensitivity and specificity in tubal patency evaluation of both procedures in comparison with diagnostic laparoscopy. Results: 54 patients were enrolled and randomly allocated into two groups: 25 patients (group I) were subjected to 2D HyFoSy procedure and 25 patients (group II) were submitted to 3D HyFoSy. The 2D-HyFoSy findings, obtained in group I, agreed with laparoscopy in 81 % of cases, with a sensitivity of 80 % and a specificity of 92 %. In group II, a correspondence was present in 88 % of examinations, with a sensitivity and specificity of 98% and 91.4% respectively. The procedure of 3D- HyFoSy was found to be faster and less painful than 2D-HyFoSy with statistically significant difference in the execution times of the two procedures (p<0.001). Conclusions: As agreed with the literature the 3D is more accurate than the 2D in the assessment of the tubal occlusion. Thus, in the diagnosis of tubal occlusion, when the patients has a positive anamnesis for pelvic pathology, it seems to us advisable using the 3D HyFoSy as the first-level examination, while, in patients with negative anamnesis for pelvic pathology, where the tubes appear obstructed in 2D HyFoSy, the 3D-HyFoSy should be indicated before submitting the patients to operative laparoscopy.