Evaluation of magnetic resonance hysterosalpingography combined with limited pelvic MRI as a one-stop diagnostic approach for female infertility

Conventional X-ray Hysterosalpingography (C-HSG) has traditionally served as the primary imaging modality for evaluating tubal patency; however, it poses limitations including exposure to ionizing radiation, patient discomfort, and suboptimal soft tissue differentiation. This study evaluates the diagnostic accuracy of magnetic resonance hysterosalpingography (MR-HSG) in assessing tubal occlusion compared to C-HSG. Thirty patients with primary or secondary infertility underwent both MR-HSG and C-HSG, and findings were statistically analyzed. MR-HSG demonstrated a sensitivity of 98% and specificity of 95%, with no significant difference in diagnostic performance between MR-HSG and C-HSG (p=0.6). Additionally, MR-HSG identified non-tubal causes of infertility, such as endometrial abnormalities and submucosal fibroids, reinforcing its broader clinical utility. These findings suggest that MR-HSG could serve as a first-line imaging modality for infertility assessment, minimising patient discomfort while providing comprehensive pelvic evaluation.