BMC pregnancy and childbirth · 2025
The value of 4-dimensional hysterosalpingo-contrast sonography in predicting the possibility of spontaneous conception in infertile women.
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Huang Hui, Bai Qiaomei, Chen Liping, Li Ping, Zhang Jun
Аннотация
BACKGROUND: Some infertile women can undergo spontaneous conception after 4-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy). However, advised period of expectant management after HyCoSy for different tubal patency was rarely recorded. This study aimed to investigate the correlation between the expected treatment time to spontaneous conception and tubal patency in infertile women after HyCoSy.
STUDY DESIGN: This was a retrospective cohort study of 984 infertile patients examined by 4D-HyCoSy from January 2021 to October 2022. A total of 776 eligible patients who tried to conceive naturally without laparoscopic surgery or assisted reproductive technology (ART) treatment after 4D-HyCoSy were analyzed. The expected time for spontaneous pregnancy was 1 year after 4D-HyCoSy. The results of HyCoSy were categorized as follows: type I, defined as both fallopian tubes patent; type II, defined as one fallopian tube patent with pathology in the other; and type III, defined as both fallopian tube pathologies. The cumulative pregnancy rate was 46.8% (363/776) within 1 year after HyCoSy, and the mean pregnancy time was 4.6 ± 2.8 months. The pregnancy rate was significantly highest in type I, reaching 55.3%, followed by type II (36.3%) and type III (16.3%) (log-rank test, P < 0.001). Kaplan-Meier curves showed that the conception frequency was highest in the first 3 months and then reached a plateau after 9 months post-HyCoSy. Multivariate Cox regression analysis showed that the patency of both fallopian tubes, as well as age, infertility duration, presence of uterine cavity lesions and endometriosis lesions, were independently associated with spontaneous pregnancy (P < 0.05).
CONCLUSION: Infertile women with at least unilateral tubal patency had a highest spontaneous pregnancy rate in the first 3 months post-HyCoSy and could be advised a certain period of expectant management. However, infertile women with bilateral tube pathology should be counseled to pursue active fertility treatment.
STUDY DESIGN: This was a retrospective cohort study of 984 infertile patients examined by 4D-HyCoSy from January 2021 to October 2022. A total of 776 eligible patients who tried to conceive naturally without laparoscopic surgery or assisted reproductive technology (ART) treatment after 4D-HyCoSy were analyzed. The expected time for spontaneous pregnancy was 1 year after 4D-HyCoSy. The results of HyCoSy were categorized as follows: type I, defined as both fallopian tubes patent; type II, defined as one fallopian tube patent with pathology in the other; and type III, defined as both fallopian tube pathologies. The cumulative pregnancy rate was 46.8% (363/776) within 1 year after HyCoSy, and the mean pregnancy time was 4.6 ± 2.8 months. The pregnancy rate was significantly highest in type I, reaching 55.3%, followed by type II (36.3%) and type III (16.3%) (log-rank test, P < 0.001). Kaplan-Meier curves showed that the conception frequency was highest in the first 3 months and then reached a plateau after 9 months post-HyCoSy. Multivariate Cox regression analysis showed that the patency of both fallopian tubes, as well as age, infertility duration, presence of uterine cavity lesions and endometriosis lesions, were independently associated with spontaneous pregnancy (P < 0.05).
CONCLUSION: Infertile women with at least unilateral tubal patency had a highest spontaneous pregnancy rate in the first 3 months post-HyCoSy and could be advised a certain period of expectant management. However, infertile women with bilateral tube pathology should be counseled to pursue active fertility treatment.