• 대한핵의학회지
• /
• 제21권2호
• /
• pp.207-211
• /
• 1987

A prospecitive study was performed to evaluate the efficacy of Radionuclide Hysterosalpingography (RNHSG), that was modified by McCalley, et al. for the evaluation of fallopian tube. Using spontaneous migration of Tc99m labelled human albumin microsphers (HAM) and images got with Gamma camera, the study was made in 20 gynecological patients (44 tubes) in an effort to confirm the anatomical patency or obstruction as well as functional one at the Department of Obstetrics and Gynecology, National Medical Center from January 1, 1986 to July 31, 1986. The efficacy was also compared with that of contrast hysterosalpingography and surgical observation. Results obtained were as follows; 1) The Radionuclide Hysterosalpingography appeared to be a simple and accurate procedure as a mean with which anatomical tubal patency, as well as functional patency can be detected, although it's some limit in showing anatomical details of uterine cavity and tubes in comparison with contrast hysterosalpingography. 2) The predicted value of tubal obstruction was 82.4%. and that of tubal patency was 88.9% respectively. Overall efficacy (percent of tube correctly classified) of Radionuclide Hysterosalpingography was 88.6%. 3) There was no nuclide related complication during and after the procedure.

• 대한디지털의료영상학회논문지
• /
• 제13권1호
• /
• pp.1-6
• /
• 2011

The purpose of our study was to determine the entrance surface dose and absorbed dose in ovary when using the metal speculum and plastic speculum in hysterosalpingography respectively. The examinations was performed in anthropomorphic phantom into which calibrated photoluminescence glass dosimeter were placed on symphysis pubis level surface and ovary area. We checked average fluoroscopy time and spot expose times during the hysterosalpingography. It was average fluoroscopy time 58 sec, spot expose 5 times. We divided the subjects into two different groups to used metal and plastic speculum. We measured 10 times of absorbed dose in the same condition of the anthropomorphic phantom. We compared two groups adsorbed dose on ovary with speculum material-related. The entrance surface dose on of plastic Speculum using group was average 17.23 mGy, absorbed dose on ovary was average 3.51 mGy. The entrance surface dose on ovary of metal Speculum using group was average 19.95 mGy, absorbed dose on ovary was average 4.14 mGy. Plastic speculum using group shows a decrease absorbed dose(17.9%) as compared with metal speculum using group. The method of plastic speculum using in hysterosalpingography. might provide us with lower radiation dose, especially in patients with childbearing stage.

• 대한생식의학회:학술대회논문집
• /
• 대한불임학회 2001년도 제2차 연수강좌
• /
• pp.7-14
• /
• 2001

• Clinical and Experimental Reproductive Medicine
• /
• 제32권3호
• /
• pp.223-230
• /
• 2005

Objective: This study was performed to evaluate the accuracy of hysterosalpingography (HSG) for evaluating female infertility patients by comparison with hysteroscopic and laparoscopic examination. Methods and Material: Total 219 infertile patients were retrospectively analyzed between January 1, 2002 and December 31, 2003. Ninety seven patients (44.3%) were primary infertility, 122 patients (55.7%) were secondary infertility. We performed hysteroscopic and laparoscopic examination on next cycle when HSG revealed any abnormal finding, and 3~6 cycles later if HSG was normal. Results: The accuracy of HSG was 65.2% compared with hysteroscopic examination (sensitivity 88.4%, specificity 46.4%, false positive rate 53.6%, false negative rate 11.6%). The most common abnormal finding of hysteroscopy was uterine synechia (67.4%) followed by endometrial polyp, uterine anomaly (e.g. uterine septum), endometrial hyperplasia. Compared with laparoscopic examination, the accuracy of HSG was 76.9% (sensitivity 98.9%, specificity 70.6%, +LR 3.36, -LR 0.02). The positive predictive value of normal patent tube was excellent (99.6%) but that of proximal tubal blockage was only 46.7%. The unilateral tubal obstruction of HSG was poor accuracy (+LR 3.85 -LR 0.68) and 70% of those was patent by laparoscopic examination. Laparoscopic examination also revealed that 53% of patients had peritubal adhesion and 37% of patients has additional pelvic findings, especially endometriosis. Among the patients had normal HSG, 53.5% patients with normal ultrasonography was diagnosed endometriosis (25.6% of them had endometriosis stage I-II). Conclusion: Normal HSG shows a high negative predictive value. Nevertheless, the incidence of associated pelvic disease in the normal HSG group is high enough to warrant diagnostic laparoscopy if nonsurgical treatment is unsuccessful. Because HSG has poor accuracy in predicting distal tubal blockage and peritubal adhesion, and poor positive predictive value of proximal tubal blockage, laparoscopic examination could be considered in abnormal HSG group.

• Clinical and Experimental Reproductive Medicine
• /
• 제14권1호
• /
• pp.1-6
• /
• 1987

The Radionuclide test (RN test) using radioactively labelled human albumin microspheres was developed recently to evaluate the patency and functional capacity of the fallopian tubes. 57 infertile women underwent this procedure as a part of their infertility work up. The results of the radionuclide evaluation were compared with those of the hysterosalpingography (HSG) and further the surgical findings of the laparoscopy and laparotomy. In 64.9%(37/57) of the cases, there was complete agreement between radionuclide test (RN test), hysterosalpingography(HSG) and surgical findings. In comparison with surgical findings, RN test showed a complete agreement rate of 89.4%(51/57), a partial agreement rate of 5.3%(3/57) and no agreement rate of 5.3%(3/57), respectively. Likewise, HSG revealed a complete agreement rate of 80.7%(46/57), a partial agreement rate of 10.5%(6/57) and no agreement 8.8%(5/57), respectively. It would appear that as opposed to the traditional HSG, RN test may give a better understanding of the functional capacity of the tube and may prove a useful method before and after tubal surgery.

• Clinical and Experimental Reproductive Medicine
• /
• 제39권2호
• /
• pp.68-72
• /
• 2012

Objective: To investigate the value of stimulated intrauterine insemination (IUI) in women with unilateral tubal occlusion. Methods: Superovulation and IUI was performed during 2003-2010 and the medical records were reviewed retrospectively. Thirty-seven infertile women (52 cycles) with unilateral tubal occlusion diagnosed by hysterosalpingography and without other causes of infertility were selected. One-hundred fourteen patients with unexplained infertility served as a control group (182 cycles). The main outcome was the clinical pregnancy rate per cycle. Results: The pregnancy rate per cycle was similar, 17.3% for the unilateral tubal occlusion group and 16.5% for the unexplained infertility group. The rate of miscarriage (11.1% vs. 23.3%) and ectopic pregnancy (11.1% vs. 6.7%) was similar between the two groups. The pregnancy rate was higher in patients with proximal occlusion (25.0%) compared with distal occlusion (13.9%) or unexplained infertility, but not statistically significant. Conclusion: Stimulated IUI can be suggested as the initial treatment option in women with unilateral proximal or distal tubal occlusion.

• Clinical and Experimental Reproductive Medicine
• /
• 제39권4호
• /
• pp.161-165
• /
• 2012

Objective: To evaluate the effect of hysterosalpingo-contrast sonography (HyCoSy) on natural conception in the infertile patient. Methods: We conducted a prospective observational study recruiting 180 patients admitted to Infertility Center of Ferrara University from January 2010 to February 2012. The essential inclusion criteria was the couple's desire to perform only diagnostic evaluation on infertility causes and to wait for natural conception before proceeding with further management. Couples were investigated with hormonal profile, semen analysis and HyCoSy. Expected time for spontaneous pregnancy was 180 days from HyCoSy. First datation sonography of pregnancy was used calculating time elapsed from HyCoSy at conception. Results: Forty patients (22.2%) obtained spontaneous pregnancy within 6 months after HyCoSy. The mean of "conception time" was 75 days. The pregnancy rate was significantly higher in the first 30 days (45%) compared to other the months of observation (p<0.0005). Multiple linear regression analysis showed that maternal age and sterility duration proved independent variables in detecting the "conception time" after HyCoSy (t=3.742, p=0.001, t=2.371, p=0.02, respectively). Conclusion: A possible beneficial effect of HyCoSy is feasible especially in the days following its execution. This temporal correlation supports its therapeutic use.

• Clinical and Experimental Reproductive Medicine
• /
• 제37권4호
• /
• pp.321-327
• /
• 2010

목적: 불임을 주소로 내원한 환자들을 대상으로 자궁 난관 조영술을 이용한 난관 불임 선별검사에서 난관 막힘의 소견을 보인 경우 선택적 난관 조영술을 시행 후 실패 시 난관 개통술을 시행하여 난관 불임치료에 있어 난관 개통술의 효용성을 알아보고 난관 막힘 부위 및 형태에 따른 난관 개통률을 비교하고자 하였다. 연구방법: 난관 불임 선별검사로서 자궁 난관 조영술을 시행하였으며 자궁 난관 조영술 상 난관 막힘 소견을 보인 215명의 342개의 난관을 대상으로 후향적 연구를 진행하였다. 결과: 난관 개통술을 시행하여 342개의 난관 가운데 248개의 난관이 개통되어 72.5%의 난관 개통률을 보였다. 막힘 부위에 따른 난관 개통률은 근위부 83.8% (197/235예), 협부 45.6% (47/103예), 원위부 100% (4/4예)를 보여 자궁-난관 접합부에 가까운 막힘 일수록 높은 개통률을 보였다. 막힘 형태에 따른 개통률은 점진형은 92.3% (157/170예), 오목형은 80.2% (69/86예), 볼록형은 25.5% (22/86예)의 난관 개통률을 보였다. 난관 막힘 부위와 형태를 종합하여 볼때 난관 근위부 점진형 막힘의 경우 91.6% (143/156예)의 높은 개통률을 보인 반면 난관 협부 볼록형 막힘의 경우에는 개통률이 11.3% (6/53예)에 불과하였다. 난관 개통에 성공한 156명 가운데 98명에서 임신에 성공하여 62.7%의 임신율을 보였다. 결론: 난관 개통술은 자궁 경부를 통한 시술로 수술적 방법이나 체외수정시술의 난자 채취에 비해 덜 침습적인 방법으로 입원치료가 필요하지 않으며 비교적 적은 비용으로 불임의 원인을 극복할 수 있는 장점이 있어 난관 원인에 의한 불임 환자에서 우선적으로 시행해 볼 수 있는 효과적인 치료 방법이라 할 수 있다.

• Clinical and Experimental Reproductive Medicine
• /
• 제7권1_2호
• /
• pp.11-20
• /
• 1980

Hysterosalpingograms (H.S.G.) have been done for several decades to determine causative factors in female infertility. However, the H.S.G. only reverals uterine cavity and tubal patency or inpatency. The author prefers to find more details in regard to the status and condition of the female reproductive organs and their surrounding tissue as they pertain to infertility. H.S.G. in combination with laparoscopic examination reveals the following results. Preparation and method of performance of H.S.G. during laparoscopy in a healthy reproductive age women are as follows. When laparoscopy is not contraindicated, NPO is ordered with routine bowel preparation. Analgesics administered by injection prior to procedure are valium 10mgs and pethidine 50-100mgs. The radiographic procedure is the same as for any HSG technique. During laparoscopy a solution of 3 to 10 ccs. of 60% hypaque sodium is used. Fluroscopic scout films are obtained A-P and oblique views as well as a delayed check film. 1. Age distribution of primary and secondary infertility in this studies involving tubal factors was as follows: 20-29 age group showed 46% incidence and in the 30-39 age group, 50% incidence. Duration of infertility in this study group was the following: 1-2 years showed 26.7%, 3-5 years 53.8%, and 6-9 years 13.3%. 2. Indications of laparoscopic examination were as follows: Secondary infertility in 35% of the cases, obscure tubal occlusion on previous H.S.G. in 25%, unknown origin in 11.7%, and the remaining cases included pelvic pain, small masses, dysmenorrhea, and uterine anomaly. The laparoscopic examination showed clearly the reproductive organs and the surrounding tissues in the pelvic cavity. The abnormal tubal findings there revealed were tuberculous salpingitis and hydrosalpinx in 10% each, endometriosis and peritubabl adhesions in 6.7% each, biconuate uterus in 3.3%. The remaining 58.3% of the cases showed normal findings. Laparoscopic observation for possible myoma nodules, streak ovary, and peritubal adhesions was also done at this time. 3. Comparative tubal findings in combined H.S.G. and laparoscopic examination revealed the following. Bilateral tubal occlusion was present in 14% (7cases) on laparoscopic examination but on H.S.G. 38% (19 cases) were noted. However, tubal occlusion and peritubal adhesions were found in 26% (13 cases) upon laparoscopy and only 8% (4 cases) on H.S.G. examination alone. Normal pelvic findings were present in 60% (27 cases).