The accuracy of hysterosalpingography in the diagnosis of tubal pathology: A meta-analysis

P. Swart, B. W.J. Mol, F. Van der Veen*, M. Van Beurden, W. K. Redekop, P. M.M. Bossuyt

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

281 Citations (Scopus)


Objective: To assess the value of hysterosalpingography (HSG) in diagnosing tubal patency and peritubal adhesions using laparoscopy with chromopertubation as the gold standard. Design: Meta-analysis of 20 studies comparing HSG and laparoscopy for tubal patency and peritubal adhesions. Patients: Four thousand one hundred seventy-nine patients with infertility in 20 studies. Intervention: Hysterosalpingography and diagnostic laparoscopy as part of infertility workup. Main Outcome Measure: Tubal patency and peritubal adhesions. Results: For tubal patency the reported sensitivity and specificity differed between studies. In a subset of studies that evaluated HSG and laparoscopy independently, a point estimate of 0.65 for sensitivity and 0.83 for specificity was calculated. For peritubal adhesions a summary receiver operating characteristic curve could be estimated. Conclusions: Although HSG is of limited use for detecting tubal patency because of its low sensitivity, its high specificity makes it a useful test for ruling in tubal obstruction. For the evaluation of peritubal adhesions HSG is not reliable.

Original languageEnglish
Pages (from-to)486-491
Number of pages6
JournalFertility and Sterility
Issue number3
Publication statusPublished - 1 Jan 1995


  • diagnostic laparoscopy
  • Hysterosalpingography
  • infertility
  • meta-analysis
  • peritubal adhesions
  • tubal patency


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