Role of Transvaginal Sonography Following Hysterosalpingography in Confirming and Characterizing Tubal Blockage

Introduction:  Twenty five to thirty five percent of female infertility cases were caused by tubal factors, though it offers little morphological detail. Hysterosalpingography (HSG) is still the recommended first test for tubal clarity evaluation. A non-surgical option that may be used to more characterize tubal disease is transvaginal sonography (TVS). Aim of the Study: To evaluate the role of TVS following HSG in confirming and characterizing tubal blockage in infertile women. Methodology: This observational study included 59 infertile women who underwent both HSG and subsequent TVS at our institution. Demographic data, medical history, and surgical background were recorded. HSG was performed using standard radiographic contrast technique. TVS was conducted by experienced sonographers who were aware of HSG findings. Cross-tabulation analysis assessed concordance between modalities. Results: Mean age was 29.5 years; 50.8% had primary and 49.2% secondary infertility. HSG demonstrated right tube blockage in 27.1% and left tube blockage in 25.4%. TVS showed perfect concordance with HSG 100% agreement for both patent/normal and blocked/dilated categories. Those 20 patients who had confirmed blockage, TVS identified hydrosalpinx in 33.9% containing 10 bilateral, 6 right, 4 left and adhesions in 25.4% containing 9 bilateral, 4 right, 2 left. Conclusion: TVS following HSG confirms tubal blockage while providing morphological characterization. Hydrosalpinx detection carries direct therapeutic implications for IVF planning. We recommend routine TVS when HSG demonstrates tubal obstruction to optimize fertility management.