Background: Infertility is a common reproductive health problem, with uterine, tubal, and ovarian abnormalities being major contributing factors. Transvaginal sonography (TVS) and hysterosalpingography (HSG) are widely used first-line imaging modalities for evaluating female infertility. Understanding the distribution and concordance of findings between these modalities is essential for comprehensive diagnostic assessment. Objective: To evaluate the pattern of findings on transvaginal sonography and hysterosalpingography among women presenting with infertility and to assess the diagnostic agreement between the two modalities. Methods: This retrospective cross-sectional study analyzed recorded data from 100 women who underwent both TVS and HSG as part of routine infertility evaluation at the Institute of Nuclear Medicine and Allied Sciences (INMAS), Sylhet, and a private diagnostic center. Frequencies and percentages of imaging findings were calculated. Cross-tabulation and chi-square testing were performed to assess associations, and Cohen’s kappa (κ) statistic was used to evaluate inter-modality agreement. Results: TVS detected abnormalities in 36% of participants, most commonly myomas, ovarian cysts, and polycystic ovarian disease. HSG demonstrated abnormalities in 22% of cases, predominantly left-sided (7%) and bilateral tubal block (6%). A statistically significant association was observed between TVS and HSG findings (χ² ≈ 285.66, p < 0.001). However, diagnostic agreement was slight, with a Cohen’s kappa value of approximately 0.10, indicating limited concordance beyond chance. Conclusion: TVS and HSG demonstrate distinct but complementary diagnostic roles in infertility evaluation. The low inter-modality agreement highlights that reliance on a single modality may overlook relevant pathology. Combined use of TVS and HSG remains essential for comprehensive infertility assessment.
Nahar et al. (Mon,) studied this question.