Fertility Improvement of Hysteroscopy with Chromopertubation in the Management of Infertile Women with Hysterosalpingography Evidence of Abnormal Tubal Patency: A Prospective Comparative Study

Purpose: To investigate the clinical value of hysteroscopy with chromopertubation (HSC) in infertile patients with hysterosalpingo-graphy (HSG) evidence of abnormal tubal patency.Methods: The study consisted of 296 patients. HSG was performed as a preliminary test for the evaluation of fallopian tube status. Patients who desired to conceive naturally were treated with HSC in the next month or followed-up without additional treatment. The primary outcome was natural clinical pregnancy within 12 months after the procedure.Results: In total, the number of clinical pregnancies was estimated to be 70 of 143 (48.95%) clinical pregnancies with management by HSC and 65 of 153 (42.48%) pregnancies with management comprising follow-up without additional treatment, and this was not significantly different (Log rank test, P = 0.516). Subgroup analysis showed that among women with bilateral abnormalities by HSG, patients receiving management with HSC tended to have a higher probability of pregnancy throughout the follow-up period than women without HSG (Log rank test, P = 0.005). No corresponding significant difference was found for women with a unilateral abnormality (P = 0.674).Conclusion: HSC shows potential fertility improvement value for infertile patients with tubal factors. HSC may be complementary to HSG and could be incorporated as a modality of the fertility work-up.