Comparative study between hysterosalpingo-contrast sonography and hysterosalpingography in evaluating tubal patency at Aminu Kano teaching hospital, Kano

Abstract

Background: Tubal diseases contribute significantly to secondary infertility, affecting 25-35% of couples seeking
infertility treatment. Traditional methods for assessing tubal patency, such as laparoscopy and dye tests, are invasive,
costly, and require specialized expertise. Hysterosalpingography (HSG) is an alternative, but it involves pain and
radiation exposure. This study aimed to compare the effectiveness of Hysterosalpingo-contrast Sonography (HyCoSy)
using a saline and air mixture to HSG in assessing tubal patency in infertility patients at Aminu Kano Teaching Hospital.
Methodology: A cross-sectional study involved 50 consenting patients seeking fertility evaluation. The researchers used
a semi-structured questionnaire to gather demographic information. HyCoSy with the saline and air mixture was
performed between the 5th and 10th day of the menstrual cycle, followed by HSG within the next five days. The patency
of each fallopian tube was assessed, and pain levels experienced during both procedures were recorded using a
numerical rating scale.
Results: The results indicated that 68.8% of patients had bilateral patent tubes according to HyCoSy, while 60.4% were
found to have patent tubes with HSG. A comparison of findings for individual tubes showed an 89.6% concordance rate
between the two tests, with a Kappa index of 0.73, indicating substantial agreement. Importantly, patients reported
significantly less pain during the HyCoSy procedure (mean NRS score of 4.1) compared to HSG (mean NRS score of
7.1).
Conclusion: This study demonstrated that HyCoSy using a saline and air mixture is highly comparable to HSG in
assessing tubal patency. Notably, HyCoSy was preferred by patients due to its reduced pain and better tolerance, with
minimal adverse effects. This suggests that HyCoSy may be a more patient-friendly and cost-effective alternative for
tubal assessment in cases of infertility.