Spontaneous pregnancy rate after hysterosalpingography versus saline infusion sonogram done under high pressure: a randomized controlled trial

ABSTRACT

Objective. A prospective, randomized controlled clinical trial was conducted from March 2020 till April 2021 on 183 eligible women recruited from the infertility outpatient Clinic of El-Shatby University Hospital, Alexandria, Egypt.
Materials and Methods. Patients were randomized into two main groups; “group A” did HSG and “group B” did conventional SIS. Patients with tubes patent under low pressure were assigned as “group B1” and patients with tubes which were occluded under low pressure were assigned as “group B2” and subjected to SIStreat. The results of tubal patency were observed and recorded in groups A and B2, either open or occluded. Pregnancy was diagnosed by serum B-HCG and with ultrasonic diagnosis of intact intrauterine gestational sac one week afterwards.
Results. Out of 93 cases performed HSG (group A); the Number of opened tubes = 79 (84.9%); the Number of occluded tubes = 14 (15.1%) cases, and pregnancy rate = 13 (14%) cases. Regarding 71 cases performed SIStreat (group B2), the Number of opened tubes = 62 (87.3%); the Number of occluded tubes = 9 (12.7%) cases, and pregnancy rate = 27 (38%) cases. There was no statistical significance difference between the two groups in rate of (opened/ occluded tubes) diagnosis (P = 0.664), but the rate of spontaneous pregnancy after 6 months was statistically significant when compared between both groups (P = <0.001), in favor of the SIStreat group. Conclusions. SIStreat is equal to the conventional HSG in diagnosis of tubal patency. Also, this method increases the rate of post-procedure pregnancy rate.