Fertility Improvement of Hysteroscopy with Chromopertubation in the Management of Infertile Women with Hysterosalpingography Evidence of Abnormal Tubal Patency: A Prospective Comparative Study.

PURPOSE: To investigate the clinical value of hysteroscopy with chromopertubation (HSC) in infertile patients with hysterosalpingography (HSG) evidence of abnormal tubal patency.

METHODS

The study consisted of 296 patients. HSG was performed as a preliminary test for the evaluation of fallopian tube status. Patients who desired to conceive naturally were treated with HSC in the next month or followed-up without additional treatment. The primary outcome was natural clinical pregnancy within 12 months after the procedure.

RESULTS

In total, the number of clinical pregnancies was estimated to be 70 of 143 (48.95%) clinical pregnancies with management by HSC and 65 of 153 (42.48%) pregnancies with management comprising follow-up without additional treatment, and this was not significantly different (Log rank test, P = 0.516). Subgroup analysis showed that among women with bilateral abnormalities by HSG, patients receiving management with HSC tended to have a higher probability of pregnancy throughout the follow-up period than women without HSG (Log rank test, P = 0.005). No corresponding significant difference was found for women with a unilateral abnormality (P = 0.674).

CONCLUSION

HSC shows potential fertility improvement value for infertile patients with tubal factors. HSC may be complementary to HSG and could be incorporated as a modality of the fertility work-up.