Comparative analysis of hysterosalpingography and hysterosalpingo-contrast sonography for assessing tubal patency in women with endometriosis-related infertility: a propensity score-matched study.

PURPOSE: This study aimed to compare the clinical pregnancy rates of hysterosalpingography (HSG) with water-based contrast and hysterosalpingo-contrast sonography (HyCoSy) to investigate their impact on fertility outcomes in women with endometriosis-related infertility.

METHODS

This retrospective study included 296 women with endometriosis-related infertility, aged 18-39, undergoing HSG or HyCoSy at the First Affiliated Hospital of Guangxi Medical University (January 2020-June 2022). Propensity score matching was applied to balance demographic and clinical variables. Clinical pregnancy outcomes were compared between the groups.

RESULTS

The HSG group showed a higher clinical pregnancy rates compared to the HyCoSy group. Logistic regression demonstrated an odds ratio (OR) of 0.41 (95% CI 0.20-0.82, p < 0.001) for clinical pregnancy in the HyCoSy group compared to HSG. After propensity score matching, the OR was 0.37 (95% CI 0.18-0.75). Similar results were observed across multivariable and IPTW analyses, suggesting that HSG may be associated with better clinical pregnancy outcomes than HyCoSy.

CONCLUSION

Hysterosalpingography (HSG) with water-based contrast appears to be associated with higher clinical pregnancy rates compared to HyCoSy in women with endometriosis-related infertility. This suggests that HSG may be a more favorable diagnostic method for optimizing fertility outcomes, though further research is needed to confirm these findings.