Algorithm of Radiological Methods to Diagnose Infertility Induced by Pelvic Organ Pathology and Fallopian Tube Abnormality

Infertility affects millions of people and has an impact on their families and communities. Estimates suggest that approximately one in every six people of reproductive age worldwide experience infertility in their lifetime. In the female reproductive system, infertility may be caused by a range of abnormalities of the ovaries, uterus, fallopian tubes, and the endocrine system, among others [1,2]. For the assessment of tubal patency there are several radiological methods used nowadays: hysterosalpingography (HSG) and sonohysterosalpingography (sonoHSG). In Our study we have used both to asses tubal patency. In 73 cases of infertile woman in their reproductive age from 25 to 36 years we have used sonoHSG and have diagnosed different abnormalities in 41% of the cases (submucosal fibroid, endometrial polip, uterine abnormalities, endometrial hyperplasia), in 42 cases we have used both HSG and sonoHSG to asses tubal patency and diagnosed different types of tubal abnormalities. Results: In our study in 44% of the cases sonoHSG clearly reveals different uterine abnormalities and the fact of tubal patency without visualization of localization of tubal blockage and/or degree of blockage as a reason of infertility. In 56% of the cases where both sonoHSG and HSG was done we could diagnose tubal patency with localization of the blockage and degree of it. Conclusion: as a conclusion we can say that in the case of structural pathologies (like fibroid, endometrial polip or uterine abnormalities e.t.c.) and patency of tubes easily diagnosed by using only sonoHSG and there is no need to extend diagnostic method thus it is possible to avoid ionizing radiation of the patient and possibilities of allergy to contrast media used during HSG. But if structural abnormalities of uterus were not seen extension of diagnostic method using HSG is helpful to visualize localization of tubal blockage and degree of it. It is widely known that localization and the degree of the tubal block do not have clinical value and has no influence on the strategy of the management.