Echohysterosalpingography: pros and cons. A systematic review

Background. Infertility is becoming ever more pressing a problem by year in Russia and worldwide. Tubal-peritoneal infertility is most frequent, with the prevalence of 42.5-80.5% in various estimates. Echohysterosalpingography is considered the today’s “gold standard” in tubal-peritoneal infertility diagnosis in women. This method is known to possess a series of limitations and adverse consequences due to painful sensations during and after check-ups that psychologically afflict women.

Objectives. An overview of current methods for inspecting fallopian tubes in reproductively impaired patients to inform promising diagnostic research.

Methods. Publications were mined and analysed in the PubMed, eLibrary, Web of Science, Cochrane Library and Cyberleninka electronic databases. The query terms were: echohysterosalpingography [эхогистеросальпингография], echohysterography [эхогистерография], infertility [бесплодие], pregnancy planning [планирование беременности], fallopian patency [проходимость маточных труб], ultrasonic diagnosis [ультразвуковая диагностика], submucous myomatous node [субмукозный миоматозный узел], incompetent uterine scar [несостоятельный рубец на матке], niche [ниша]. The topic selected was female infertility, particularly, the use of echohysterosalpingography in fallopian diagnosis in reproductively impaired women.

Results. The review covers 52 sources of the total 118 analysed. Current published evidence and its review identify a notable success of imaging techniques in the fallopian tube diagnosis in women with reproductive problems. The continually developing echohysterosalpingography technique is considered more promising for routine use. Techniques gain more value in analyses of implantation failures. The main challenges in current radiodiagnosis and monitoring of fallopian lesions at a background therapy are the inspection standardisation, disease classification, imaging diagnostic accuracy and prognostic value evaluation in patients with reproductive loss and infertility.

Conclusion. The prospective routes of research comprise the definition of optimal check-up terms, echohysterography and echohysterosalpingography diagnostic criteria descriptiveness, improving prognosis in the carrying of pregnancy and treatment efficacy control. A timely and accurate diagnosis of uterus and fallopian tubes is of paramount importance to sustain the women’s reproductive health.

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