Comparison of the Application Value of 4‐Dimensional Hysterosalpingo‐Contrast Sonography and X‐Ray Hysterosalpingography in Intrauterine Insemination

OBJECTIVES: To compare the application value of 4-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) and x-ray hysterosalpingography (HSG) in intrauterine insemination (IUI) patients. METHODS: In this retrospective study, a total of 725 infertile patients who underwent IUI in Ganzhou Maternal and Child Health Hospital from January 2023 to June 2024 were divided into 2 groups based on the type of salpingography: 535 cases in the HSG group and 190 cases in the 4D-HyCoSy group. The clinical pregnancy rates, the number of IUI cycles required to achieve clinical pregnancy, and the incidence of adverse pregnancy outcomes were compared between the 2 groups. RESULTS: There were no significant differences in baseline data between the HSG group and the 4D-HyCoSy group. The clinical pregnancy rates were 19.43% for the HSG group and 17.89% for the 4D-HyCoSy group (p = 0.66). The number of IUI cycles required to achieve clinical pregnancy was 1.55 ± 0.65 for the HSG group and 1.62 ± 0.79 for the 4D-HyCoSy group (p = 0.65). The ectopic pregnancy rates were 2.8% for the HSG group and 2.9% for the 4D-HyCoSy group (p = 0.43). The biochemical pregnancy rates were 1.9% for the HSG group and 1.6% for the 4D-HyCoSy group (p = 0.42). The early miscarriage rates were 11.5% for the HSG group and 14.7% for the 4D-HyCoSy group (p = 0.63). No significant differences were found in any of these parameters. CONCLUSION: The type of salpingography HSG and 4D-HyCoSy do not affect the clinical pregnancy outcomes in IUI. Therefore, it is recommended that HSG be phased out in favor of adopting 4D-HyCoSy as the first-line diagnostic test for tubal patency in pre-IUI evaluation.