Clinical value of four-dimensional hysterosalpingo-contrast sonography assisted by intrauterine pressure measurement for tubal patency evaluation

Abstract

We aimed to explore the clinical value of four-dimensional hys-terosalpingo-contrast sonography (4D-HyCoSy) assisted by intrauterine pres-sure measurement for evaluating tubal patency. One hundred and thirty-two patients diagnosed with tubal factor infertility from February 2018 to February 2021 were selected as subjects. With hysterosalpingography diagnosis results as the gold standard, 4D-HyCoSy was conducted for all patients, and the status of the fallopian tubes was classified into patency, occlusion, and partial occlusion. Based on the function of fallopian tubes, 4D-HyCoSy diagnosis results revealed that fallopian tubes showed bilateral patency, incomplete patency (including bilateral partial occlusion, unilateral patency, and unilateral partial occlusion, unilateral patency and unilateral occlusion), unilateral partial occlusion and unilateral occlusion, and bilateral occlusion. Thecutoff value of peak intra-uterine pressure was determined using the receiver operating characteristic curve (ROC), specificity, and the area under the ROC curve (AUC) between 4D-HyCoSy alone and 4D-HyCoSy assisted by intrauterine pressure measure-ments. There were significant differences in the peak intrauterine pressure among patients with bilateral patency, incomplete patency, unilateral partial occlusion, and unilateral and bilateral occlusions (p<0.05). The corresponding cutoff values of peak intrauterine pressure were 24.42, 36.34, and 47.68 kPa; AUC values were 0.812, 0.836, and 0.827, respectively. The FSM model showed that the AUC of 4D-HyCoSy alone, assisted by peak intrauterine pressure was 0.85, with a higher sensitivity (88.13%) than that of 4D-HyCoSy (p<0.05). 4D-HyCoSy, assisted by intrauterine pressure measurement, has an excellent value for evaluating tubal patency.