Pelvic factor infertility: Diagnosis and prognosis of various procedures

Carlo Bulletti, I. Panzini, A. Borini, E. Coccia, Paolo Levi Setti, Antonio Palagiano

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Infertile women are examined to exclude tubal occlusion or a pelvic factor through indirect tests, such as hysterosalpingography (HSG), sonohysterosalpingography/hysterosalpingosonography (SH), and/or laparoscopy (Lps). Assisted reproductive technologies (ART) are proposed to resolve infertility according to the results of the above-mentioned diagnostic procedures. Today, Lps still represents the second option after several failures of in vivo attempts and before moving to conceive in vitro. The aim of this study was to establish the diagnostic power of HSG and SH compared with that of Lps and the efficacy of ART when each single test is used as an inclusion criterion. We recruited 2560 infertile women (aged 20 to 35) to undergo diagnostic and therapeutic procedures to address their infertility in our clinical theatre. Of these, 1080 women underwent Lps and hysteroscopy (Group 1), 525 underwent HSG (Group 2), and 955 underwent SH (Group 3). The positive and negative predictive values of sonosalpingosonography were 75.8% and 91.2% and those of hysterosalpingography were 71.8% and 88.2%, respectively. Endometriosis (stage II-IV of the revised American Society for Reproductive Medicine [ASRM] classification) was diagnosed laparoscopically in 344 out of 1080 women (32%). Only 44 women (13%) with endometriosis showed bilateral tubal occlusion. Pelvic factors other than tubal occlusions are neither diagnosed nor treated in a timely manner by indirect tubal patency tests. The conventional use of HSG and/or SH may increase the time required to find an adequate treatment by which to achieve a successful pregnancy.

Original languageEnglish
Title of host publicationAnnals of the New York Academy of Sciences
Pages73-82
Number of pages10
Volume1127
DOIs
Publication statusPublished - Apr 2008

Publication series

NameAnnals of the New York Academy of Sciences
Volume1127
ISSN (Print)00778923
ISSN (Electronic)17496632

Keywords

  • Endometriosis
  • Hysterosalpingography
  • Hysterosalpingosonography
  • Hysteroscopy
  • Laparoscopy
  • Pelvic factor
  • Pelvic inflammatory disease
  • Sonohysterosalpingography
  • Sterility
  • Tubal occlusion
  • Tubal patency

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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