Page 23 - WALS Journal

Gokhan Goynumer et al
endometriosis. Of the twelve cases of bilaterally occluded tubes 6. Swart P, Mol BW, van der Veen F, van Beurden M, Redekop
detected by HSG, only 3 (25%) were confirmed to have bilateral WK, Bossuyt PM. The accuracy of hysterosalpingography in
occlusion during laparoscopy. the diagnosis of tubal pathology: a meta-analysis. Fertil Steril
These findings are in accordance with the aforementioned 1995; 64: 486-91.
7
studies. Contrary to Farum et al’s suggestions though, we are 7. Fatum M, Laufer N, Simon A. Investigation of the infertile
couple: Should diagnostic laparoscopy be performed after normal
of the thought that proceeding to IUI without a prior diagnostic hysterosalpingography in treating infertility suspected to be of
laparoscopy will lead to low pregnancy rates, a prolonged period unknown origin? Hum Reprod 2002; 17: 1-3.
of time until a pregnancy is achieved, or to the unnecessary 8. Tanahatoe S J, Hompes PG Lambalk CB. Investigation of the
referral of the patient to IVF, a very costly treatment. infertile couple: Should diagnostic laparoscopy be performed in
Speroff et al state that laparoscopy has been suggested the infertility work up programme in patients undergoing
traditionally to be an integral diagnostic procedure of most intrauterine insemination? Hum Reprod 2003 Jan; 18(1):8-11.
infertility investigatory protocols. Also, according to Speroff 9. Evers JLH, Land JA, Mol BW Evidence- based medicine for
diagnostic questions. Seminars Reprod Med 2003; 21: 9.
et al, following a normal HSG and laparoscopy, the couple is 10. Glatstein IZ, Sleeper LA, Lavy Y, Simon A, Adoni A, Palti Z,
diagnosed as suffering from unexplained infertility and should Hurwitz A, Laufer N. Observer variability in the diagnosis and
11
be referred to the next line of treatment. Moreover, the study management of the hysterosalpingogram. Fertil Steril 1997;
of Perquin et al showed that routine use of HSG at an early 67:233-37.
stage in the fertility workup prior to laparoscopy and dye does 11. Speroff L, Glass RH, Kase NG Female infertility. In Speroff L,
not influence the cumulative pregnancy rate. 21 Glass RH, Kase NG (Eds) Clinical Gynecologic Endocrinology
and Infertility, 7th edn. Lippincott Williams & Wilkins,
Philadelphia, PA, USA 2005; 1013-67.
CONCLUSION 12. DeCherney AH. Anything you can do I can do better...or
HSG demonstrated reduced positive predictive value especially differently! Fertil Steril 1987; 48: 374-76.
for bilateral proximal tubal occlusion. Moreover, HSG has a 13. Livsey R. Hysterosalpingography. Australasian Radiology 2001;
45: 98-99.
limited value for accurately identifying tubal patency. Therefore, 14. Risquez F, Confino E. Transcervical tubal cannulation, past,
we suggest that laparoscopy is necessary to rule out the present and future. Fertil Steril 1993; 60: 211-26.
existence of peritubal adhesions and mild and moderate 15. Siegler AM, Hysterosalpingography. Fertil Steril 1983; 40: 139-
endometriosis as causes of infertility in patients with abnormal 58.
HSG findings. 16. Mol BW, Collins JA, Burrows EA, van der Veen F, Bossuyt
PM. Comparison of hysterosalpingography and laparoscopy in
REFERENCES predicting fertility outcome. Hum Reprod 1999; 14:1237.
17. Yildirim M. Histerosalpingografi . In Yildirim M (Ed) Klinik
1. Balasch J. Investigation of the infertile couple: investigation of Ýnfertilite. Türkiye Klinikleri Yayýnevi, Ankara, Türkiye 2000:
the infertile couple in the era of assisted reproductive technology: 41.
A time for reappraisal Hum Reprod 2000; 15: 2251-57. 18. Drake T, Tredway D, Buchanan G, Takaki N and Daane T.
2. Simon A, Laufer N. Unexplained infertility: a reappraisal. Ass Unexplained infertility. A reappraisal Obstet Gynecol. 1977;
Reprod Rev 1993; 3: 26-36. 50: 644-46.
3. Fayez JA, Mutie G, Schneider PJ. The diagnostic value of 19. Badawi IA, Fluker MR, Bebbington MW. Diagnostic
hysterosalpingography and laparoscopy in infertility laparoscopy in infertile women with normal
investigation . Int J Fertil 1988; 33: 98-101 hysterosalpingograms. J Reprod. Med 1999; 44: 953-57.
4. Corson SL, Cheng A, Gutmann JN. Laparoscopy in the normal 20. Hening I, Prough SG, Cheatwood M and Delong E.
infertile patient: A question revisited. J Am Assoc Gynecol Hysterosalpingography, laparoscopy and hysteroscopy in
Laparosc 2000; 7: 317-24. infertility. A comparative study . J Reprod Med 1991; 36:573-75.
5. Strandell A, Lindhard A, Waldenstrom U, Thorburn J, Janson 21. Perquin DAM, Dorr PJ, de Craen AJM, Helmerhorst FM.
PO, Hamberger L. Hydrosalpinx and IVF outcome: A Routine use of hysterosalpingography prior to laparoscopy in
prospective, randomized multicentre trial in Scandinavia on the fertility workup: A multicenter randomized controlled trial.
salpingectomy prior to IVF. Hum Reprod 1999; 14: 2762-69. Hum Reprod 2006; 21(5): 1227-31.

26