Study ObjectiveTo evaluate whether the presence of a visualizable “flow” effect in the fallopian tube ostia in hysteroscopic routine evaluation is predictive of tube patency.DesignA retrospective cohort study (Canadian Task Force Classification II-2).SettingData from all patients who underwent surgery because of infertility at the study center between 2008 and 2016 were analyzed retrospectively. The main outcome parameter was fallopian tube patency as assessed by laparoscopic chromopertubation. The predictive parameters tested were the presence of hysteroscopic tube “flow,” general patient characteristics, and intraoperative findings.PatientsFive hundred eleven infertile women who underwent combined hysteroscopy and laparoscopy were included.InterventionsAll women underwent combined hysteroscopy and laparoscopy. Some had other interventions when necessary, but no additional interventions were taken because of this study.ResultsIn an analysis of 998 fallopian tubes, the hysteroscopic assessment of fallopian tube “flow” was highly accurate in predicting fallopian tube patency (p?.001), with a sensitivity of 86.4% (95% confidence interval [CI], 83.7–88.8) and a specificity of 77.6% (95% CI, 72.1–82.5). Risk factors for a false-negative hysteroscopy result were the presence of uterine myomas (odds ratio [OR]?=?2.11; 95% CI, 1.10–4.05; p?=?.025), the presence of a hydrosalpinx on the analyzed side (OR?=?2.50, 95% CI, 1.17–5.34; p?=?.019), and the presence of peritubal adhesions surrounding the analyzed tube (OR?=?2.87; 95% CI, 1.21–6.76; p?=?.016).ConclusionA visualizable tube “flow” in hysteroscopy was accurate in the prediction of tubal patency, with a positive predictive value of about 91%. Knowledge about hysteroscopic fallopian tube “flow” can help to plan the future approach in an individual patient. |