Comparative study of hysterosalpingography and laparoscopy in infertile patients.

The diagnostic accuracy of hysterosalpingography (HSG) and laparoscopy was investigated in 168 consecutive patients with infertility of at least 2 years' duration. There was agreement between the results of both methods in 57.7 per cent of the patients. Among 54 patients having normal HSG, 16 (29.6 per cent) exhibited abnormalities at laparoscopy. Among 114 patients with abnormal HSG, 28 (24.6 per cent) had entirely normal internal genitalia at laparoscopy. The greatest discrepancy between the HSG and laparoscopic diagnoses was found in peritubal adhesions. Intrauterine abnormalities were diagnosed by HSG in only 2.4 per cent of the patients. Complications of laparoscopy were few and none was serious. For a conclusive evaluation of the tubal factor in infertility, one must consider abandoning HSG entirely in favor of laparoscopy.