Sonohysterosalpingography with transvaginal color Doppler and three-dimensional ultrasound: State of the art

The overwhelming majority of asymptomatic patients requiring evaluation for tubal function or tubal patency are women who are experiencing infertility problems. However, not all of them have tubal occlusion or even tubal pathology. There is a need to acquire experience and objective information about the capabilities of newer methods for evaluation of tubal structure and function that are less risky and invasive than those currently available for the growing number of women who require these studies. Several ultrasound techniques, such as transvaginal color Doppler sonography (TCDS), sonohysterosalpingography (SHSG), and three-dimensional sonography (3DS), are capable of providing diagnostic information that, in some cases, is equivalent to the information afforded by established techniques that require exposure to radiation, such as hysterosalpingography (HSG), or that are more invasive, such as hysteroscopy or diagnostic laparoscopy. Our experience, along with that of other investigators who have published reports on their experiences with these techniques, suggests that SHSG and TCDS may become initial diagnostic methods of choice for the growing number of women who have delayed pregnancy until late in their reproductive years or whose fertility is impaired by exposure to sexually acquired tubal pathogens.