current methods of tubal patency assessment英文资料.pdfVIP

Current methods of tubal patency assessment Rhiana D. Saunders, M.D., James M. Shwayder, M.D., J.D., and Steven T. Nakajima, M.D. Department of Obstetrics, Gynecology and Women’s Health, University of Louisville, Louisville, Kentucky Objective: To evaluate the scientific literature on current methods of uterine cavity and tubal patency assessment. Design: Review of literature and appraisal of relevant articles using MEDLINE, OVID, EMBASE, and Cochrane on-line databases. Result(s): Current pelvic imaging subfertility investigations are compared with the gold standard laparoscopy. The technical aspects, associated risks, potential advantages, and weighted utility of each screening study are discussed. A comprehensive analysis of the clinical evidence regarding the safety, tolerance, and accuracy of hysterosalpingo- contrast sonography compared with alternative screening studies and/or laparoscopy is reviewed. Conclusion(s): Increasing evidence supports the more recently described hysterosalpingo-contrast sonography procedure as an acceptable screening study for the subfertile patient with the potential advantage that it is a comprehensive evaluation, methodologically simple, cost effective, and time efficient. (Fertil Steril 2011;95: 2171–9. 2011 by American Society for Reproductive Medicine.) Key Words: Subfertility, sonohysterography, hysterosalpingogram, hysterosalpingo-contrast sonography The optimal initial infertility investigation protocol is diagnostically studies: HSG, sonohysterography, HyCoSy, and laparoscopy with accurate, expeditious, cost-effective, dependable, and minimally in- chromopertubation. vasive. The current established diagnostic screening tests for tubal patency are