Diagnostic Value of Hysterosalpingography

Objective: Hysterosalpingography (HSG) is a contrast-enhanced, radiographic examination method of the internal female reproductive organs, which is used in the context of infertility diagnostics for the clarification of uterine malformations. The aim of this study was to investigate the significance of HSG as a diagnostic method in reproductive medicine. Methods: The results of HSG examinations from the Clinic for Reproductive Medicine and Andrology of the University Hospital Halle (Saale) between 2006 and 2020 were retrospectively examined. Results: Normal uterine findings were diagnosed by HSG in 151(51.01%) patients. The most common uterine malformation was uterus arcuatus, which was found in 46 patients (15.54%); 30(10.14%) patients had uterus bicornis unicollis. Uterus bicornis, unicornis, and subseptus were present in 5(1.69%) patients each. A duplex uterus was detected in 3(1.01%) patients, and malformations of a uterus arcuatum unicollis, uterus septus, bicornis subseptus, and uterus corpora in case of sectio bicornis were detected in 1(0.34%) patient each. A comparison of HSG findings with those from initial baseline diagnostics (gynecologic manual examination, sonography, etc.) revealed a correlation of findings in 105 cases (35.84%) and divergence of findings in 79 cases (26.96%). With the assistance of the HSG findings, further specification of the previously collected findings was achieved in 27 cases (9.22%). The diagnostic significance of HSG in reproductive medicine was demonstrated by the fact that findings were obtained and could not be detected in the preliminary examinations. In addition, basic diagnostic findings were confirmed by HSG, and conversely, previously collected findings could be further specified. HSG is a less invasive diagnostic imaging procedure with a short examination time. The fluoroscopy time is usually only a few seconds. Therefore, the radiation exposure is negligible. Conclusion: HSG is a method of radiologic examination that can be used to diagnose and specify uterine malformations. The diagnosis by HSG often opens up new therapeutic options to correct uterine malformations.