The Blinking Test (Faheem’s Approach): A Promising Tool for Assessing Tubal Patency and Blockage

Abstract

Background: There are various diagnostic tests available to determine tubal patency. Laparoscopy with chromopertubation, with or  without contemporaneous hysteroscopy, is now the "gold standard" for tubal assessment.

Objective: This study aimed to evaluate the  specificity and sensitivity of hysteroscopic tubal patency assessment using the tubal ostium movement (blinking test).

Method: This  cross-sectional study was conducted at Aswan Specialized Hospital, Aswan, Egypt. The study involved 100 infertile patients in the period  from Jan 2022 to June 2022. Participants were recruited from the Outpatient population visiting the Gynecological Clinic at ABC Fertility  Center. Those who underwent hysteroscopy were further offered laparoscopic chromopertubation to complete the assessment, all within  the same setting.

Results: The blinking test showed a sensitivity of 82.50% for detecting right tubal patency and 92.31% for  detecting left tubal patency, along with a specificity of 100% for both right and left tubal patency. Both the positive predictive value and  negative predictive value were 100%. The overall accuracy of the blinking test was 87.27% for right tubal patency and 94.55% for left tubal  patency. Furthermore, the blinking test's diagnostic value was supported by the favorable area under the curve (AUC) values, ranging  from 0.87 to 0.961 in the ROC curve analysis.

Conclusion: The blinking test showed promising results as a diagnostic method for  assessing tubal patency in infertile patients. It is a useful tool for assessing tubal factor infertility because of its excellent sensitivity,  specificity, positive predictive value, negative predictive value, and accuracy.