Comparison of sonohysterography to hysterosalpingogram for tubal patency assessment in a multicenter fertility treatment trial among women with polycystic ovary syndrome

Mindy S. Christianson, Richard Legro, Susan Jin, Esther Eisenberg, Michael P. Diamond, Karl R. Hansen, Wendy Vitek, Aaron K. Styer, Peter Casson, Christos Coutifaris, Gregory M. Christman, Ruben Alvero, Elizabeth E. Puscheck, Alicia Y. Christy, Fangbai Sun, Heping Zhang, Alex J. Polotsky, Nanette Santoro

Research output: Contribution to journalArticle

Abstract

Purpose: To compare saline infusion sonohysterography (SIS) versus hysterosalpingogram (HSG) for confirmation of tubal patency. Methods: Secondary analysis of a randomized controlled trial, Pregnancy in Polycystic Ovary Syndrome II (PPCOS II). Seven hundred fifty infertile women (18–40 years old) with polycystic ovary syndrome (PCOS) were randomized to up to 5 cycles of letrozole or clomiphene citrate. Prior to enrollment, tubal patency was determined by HSG, the presence of free fluid in the pelvis on SIS, laparoscopy, or recent intrauterine pregnancy. Logistic regression was conducted in patients who ovulated with clinical pregnancy as the outcome and HSG or SIS as the key independent variable. Results: Among women who ovulated, 414 (66.9%) had tubal patency confirmed by SIS and 187 (30.2%) had at least one tube patent on HSG. Multivariable analysis indicated that choice of HSG versus SIS did not have a significant relationship on likelihood of clinical pregnancy, after adjustment for treatment arm, BMI, duration of infertility, smoking, and education (OR 1.14, 95% CI 0.77, 1.67, P = 0.52). Ectopic pregnancy occurred more often in women who had tubal patency confirmed by HSG compared to SIS (2.8% versus 0.6%, P = 0.02). Conclusions: In this large cohort of women with PCOS, there was no significant difference in clinical pregnancy rate between women who had tubal patency confirmed by HSG versus SIS. SIS is an acceptable imaging modality for assessment of tubal patency in this population.

Original languageEnglish (US)
JournalJournal of Assisted Reproduction and Genetics
DOIs
StateAccepted/In press - Jan 1 2018

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Polycystic Ovary Syndrome
Fertility
letrozole
Pregnancy
Therapeutics
Clomiphene
Ectopic Pregnancy
Pregnancy Rate
Pregnancy Outcome
Pelvis
Laparoscopy
Infertility
Arm
Randomized Controlled Trials
Logistic Models
Smoking
Education
Population

All Science Journal Classification (ASJC) codes

  • Reproductive Medicine
  • Genetics
  • Obstetrics and Gynecology
  • Developmental Biology
  • Genetics(clinical)

Cite this

Christianson, Mindy S. ; Legro, Richard ; Jin, Susan ; Eisenberg, Esther ; Diamond, Michael P. ; Hansen, Karl R. ; Vitek, Wendy ; Styer, Aaron K. ; Casson, Peter ; Coutifaris, Christos ; Christman, Gregory M. ; Alvero, Ruben ; Puscheck, Elizabeth E. ; Christy, Alicia Y. ; Sun, Fangbai ; Zhang, Heping ; Polotsky, Alex J. ; Santoro, Nanette. / Comparison of sonohysterography to hysterosalpingogram for tubal patency assessment in a multicenter fertility treatment trial among women with polycystic ovary syndrome. In: Journal of Assisted Reproduction and Genetics. 2018.
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title = "Comparison of sonohysterography to hysterosalpingogram for tubal patency assessment in a multicenter fertility treatment trial among women with polycystic ovary syndrome",
abstract = "Purpose: To compare saline infusion sonohysterography (SIS) versus hysterosalpingogram (HSG) for confirmation of tubal patency. Methods: Secondary analysis of a randomized controlled trial, Pregnancy in Polycystic Ovary Syndrome II (PPCOS II). Seven hundred fifty infertile women (18–40 years old) with polycystic ovary syndrome (PCOS) were randomized to up to 5 cycles of letrozole or clomiphene citrate. Prior to enrollment, tubal patency was determined by HSG, the presence of free fluid in the pelvis on SIS, laparoscopy, or recent intrauterine pregnancy. Logistic regression was conducted in patients who ovulated with clinical pregnancy as the outcome and HSG or SIS as the key independent variable. Results: Among women who ovulated, 414 (66.9{\%}) had tubal patency confirmed by SIS and 187 (30.2{\%}) had at least one tube patent on HSG. Multivariable analysis indicated that choice of HSG versus SIS did not have a significant relationship on likelihood of clinical pregnancy, after adjustment for treatment arm, BMI, duration of infertility, smoking, and education (OR 1.14, 95{\%} CI 0.77, 1.67, P = 0.52). Ectopic pregnancy occurred more often in women who had tubal patency confirmed by HSG compared to SIS (2.8{\%} versus 0.6{\%}, P = 0.02). Conclusions: In this large cohort of women with PCOS, there was no significant difference in clinical pregnancy rate between women who had tubal patency confirmed by HSG versus SIS. SIS is an acceptable imaging modality for assessment of tubal patency in this population.",
author = "Christianson, {Mindy S.} and Richard Legro and Susan Jin and Esther Eisenberg and Diamond, {Michael P.} and Hansen, {Karl R.} and Wendy Vitek and Styer, {Aaron K.} and Peter Casson and Christos Coutifaris and Christman, {Gregory M.} and Ruben Alvero and Puscheck, {Elizabeth E.} and Christy, {Alicia Y.} and Fangbai Sun and Heping Zhang and Polotsky, {Alex J.} and Nanette Santoro",
year = "2018",
month = "1",
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doi = "10.1007/s10815-018-1306-2",
language = "English (US)",
journal = "Journal of Assisted Reproduction and Genetics",
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Christianson, MS, Legro, R, Jin, S, Eisenberg, E, Diamond, MP, Hansen, KR, Vitek, W, Styer, AK, Casson, P, Coutifaris, C, Christman, GM, Alvero, R, Puscheck, EE, Christy, AY, Sun, F, Zhang, H, Polotsky, AJ & Santoro, N 2018, 'Comparison of sonohysterography to hysterosalpingogram for tubal patency assessment in a multicenter fertility treatment trial among women with polycystic ovary syndrome', Journal of Assisted Reproduction and Genetics. https://doi.org/10.1007/s10815-018-1306-2

Comparison of sonohysterography to hysterosalpingogram for tubal patency assessment in a multicenter fertility treatment trial among women with polycystic ovary syndrome. / Christianson, Mindy S.; Legro, Richard; Jin, Susan; Eisenberg, Esther; Diamond, Michael P.; Hansen, Karl R.; Vitek, Wendy; Styer, Aaron K.; Casson, Peter; Coutifaris, Christos; Christman, Gregory M.; Alvero, Ruben; Puscheck, Elizabeth E.; Christy, Alicia Y.; Sun, Fangbai; Zhang, Heping; Polotsky, Alex J.; Santoro, Nanette.

In: Journal of Assisted Reproduction and Genetics, 01.01.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of sonohysterography to hysterosalpingogram for tubal patency assessment in a multicenter fertility treatment trial among women with polycystic ovary syndrome

AU - Christianson, Mindy S.

AU - Legro, Richard

AU - Jin, Susan

AU - Eisenberg, Esther

AU - Diamond, Michael P.

AU - Hansen, Karl R.

AU - Vitek, Wendy

AU - Styer, Aaron K.

AU - Casson, Peter

AU - Coutifaris, Christos

AU - Christman, Gregory M.

AU - Alvero, Ruben

AU - Puscheck, Elizabeth E.

AU - Christy, Alicia Y.

AU - Sun, Fangbai

AU - Zhang, Heping

AU - Polotsky, Alex J.

AU - Santoro, Nanette

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Purpose: To compare saline infusion sonohysterography (SIS) versus hysterosalpingogram (HSG) for confirmation of tubal patency. Methods: Secondary analysis of a randomized controlled trial, Pregnancy in Polycystic Ovary Syndrome II (PPCOS II). Seven hundred fifty infertile women (18–40 years old) with polycystic ovary syndrome (PCOS) were randomized to up to 5 cycles of letrozole or clomiphene citrate. Prior to enrollment, tubal patency was determined by HSG, the presence of free fluid in the pelvis on SIS, laparoscopy, or recent intrauterine pregnancy. Logistic regression was conducted in patients who ovulated with clinical pregnancy as the outcome and HSG or SIS as the key independent variable. Results: Among women who ovulated, 414 (66.9%) had tubal patency confirmed by SIS and 187 (30.2%) had at least one tube patent on HSG. Multivariable analysis indicated that choice of HSG versus SIS did not have a significant relationship on likelihood of clinical pregnancy, after adjustment for treatment arm, BMI, duration of infertility, smoking, and education (OR 1.14, 95% CI 0.77, 1.67, P = 0.52). Ectopic pregnancy occurred more often in women who had tubal patency confirmed by HSG compared to SIS (2.8% versus 0.6%, P = 0.02). Conclusions: In this large cohort of women with PCOS, there was no significant difference in clinical pregnancy rate between women who had tubal patency confirmed by HSG versus SIS. SIS is an acceptable imaging modality for assessment of tubal patency in this population.

AB - Purpose: To compare saline infusion sonohysterography (SIS) versus hysterosalpingogram (HSG) for confirmation of tubal patency. Methods: Secondary analysis of a randomized controlled trial, Pregnancy in Polycystic Ovary Syndrome II (PPCOS II). Seven hundred fifty infertile women (18–40 years old) with polycystic ovary syndrome (PCOS) were randomized to up to 5 cycles of letrozole or clomiphene citrate. Prior to enrollment, tubal patency was determined by HSG, the presence of free fluid in the pelvis on SIS, laparoscopy, or recent intrauterine pregnancy. Logistic regression was conducted in patients who ovulated with clinical pregnancy as the outcome and HSG or SIS as the key independent variable. Results: Among women who ovulated, 414 (66.9%) had tubal patency confirmed by SIS and 187 (30.2%) had at least one tube patent on HSG. Multivariable analysis indicated that choice of HSG versus SIS did not have a significant relationship on likelihood of clinical pregnancy, after adjustment for treatment arm, BMI, duration of infertility, smoking, and education (OR 1.14, 95% CI 0.77, 1.67, P = 0.52). Ectopic pregnancy occurred more often in women who had tubal patency confirmed by HSG compared to SIS (2.8% versus 0.6%, P = 0.02). Conclusions: In this large cohort of women with PCOS, there was no significant difference in clinical pregnancy rate between women who had tubal patency confirmed by HSG versus SIS. SIS is an acceptable imaging modality for assessment of tubal patency in this population.

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U2 - 10.1007/s10815-018-1306-2

DO - 10.1007/s10815-018-1306-2

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