{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:35:59Z","timestamp":1785418559281,"version":"3.56.0"},"reference-count":24,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002842","name":"Chiang Mai University","doi-asserted-by":"crossref","award":["80-68"],"award-info":[{"award-number":["80-68"]}],"id":[{"id":"10.13039\/501100002842","id-type":"DOI","asserted-by":"crossref"}]},{"award":["80-68"],"award-info":[{"award-number":["80-68"]}],"id":[{"id":"https:\/\/ror.org\/05m2fqn25","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Accurate evaluation of fallopian tube patency is an essential step in infertility assessment. This study investigated the diagnostic capability of saline infusion sonography combined with color Doppler flow (SIS-CF), using laparoscopic chromopertubation as the comparator method. Methods: A prospective diagnostic accuracy study was conducted between January and November 2025 at the Infertility Unit, Chiang Mai University Hospital, Thailand. Women requiring laparoscopic assessment for infertility evaluation or preconception investigation were consecutively enrolled. Each participant underwent SIS-CF immediately before laparoscopic chromopertubation within the same operative session. Primary outcomes included diagnostic indices for tubal patency. Secondary outcomes included procedural duration and perioperative safety. Results: Forty-four women (88 fallopian tubes) were included. SIS-CF demonstrated sensitivity of 89.4% (95% CI 78.1\u201395.9) and specificity of 95.5% (95% CI 77.2\u201399.9). Positive and negative predictive values were 98.3% and 75.0%, respectively. Likelihood ratios were 19.65 (positive) and 0.11 (negative), with overall accuracy of 90.9% (95% CI 82.9\u201395.8). Median procedure duration was 5.7 min for SIS-CF and 3.0 min for laparoscopic chromopertubation. No adverse events were recorded. Conclusions: SIS-CF demonstrated favorable diagnostic characteristics for evaluation of tubal patency. The technique provided functional information regarding tubal status while maintaining a minimally invasive profile. Further investigation is warranted to determine its role within routine infertility workups.<\/jats:p>","DOI":"10.3390\/diagnostics16091287","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T19:24:51Z","timestamp":1777317891000},"page":"1287","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Performance of Saline Infusion Sonography with Color Doppler Flow (SIS-CF) for Assessing Tubal Patency: A Prospective Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Pantana","family":"Bangsomboon","sequence":"first","affiliation":[{"name":"Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4864-3078","authenticated-orcid":false,"given":"Worashorn","family":"Lattiwongsakorn","sequence":"additional","affiliation":[{"name":"Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7204-5783","authenticated-orcid":false,"given":"Tawiwan","family":"Panthasri","sequence":"additional","affiliation":[{"name":"Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ubol","family":"Saeng-anan","sequence":"additional","affiliation":[{"name":"Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6775-8607","authenticated-orcid":false,"given":"Usanee","family":"Sanmee","sequence":"additional","affiliation":[{"name":"Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8942-0399","authenticated-orcid":false,"given":"Natnita","family":"Mattawanon","sequence":"additional","affiliation":[{"name":"Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natpat","family":"Jansaka","sequence":"additional","affiliation":[{"name":"Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1093\/humupd\/dmaa047","article-title":"IVF and other ART in low- and middle-income countries: A systematic landscape analysis","volume":"27","author":"Chiware","year":"2021","journal-title":"Hum. Reprod. Update"},{"key":"ref_2","unstructured":"Ngamsomsak, R. (2019). Situation and Determinants of Infertility Among Women in Thailand. [Master\u2019s Thesis, Chulalongkorn University]."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Practice Committee of the American Society for Reproductive Medicine (2015). Role of tubal surgery in the era of assisted reproductive technology: A committee opinion. Fertil. Steril., 103, e37\u2013e43.","DOI":"10.1016\/j.fertnstert.2015.03.032"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1016\/j.fertnstert.2024.04.003","article-title":"Initial fertility evaluation with saline sonography vs. hysterosalpingography: It is debate-tubal","volume":"121","author":"Nguyen","year":"2024","journal-title":"Fertil. Steril."},{"key":"ref_5","first-page":"777","article-title":"Diagnostic accuracy of Saline Infusion sonohystero-salpingography (SIS) as compared to Hystero-salpingography (HSG) in the assessment of sub-fertile women","volume":"69","author":"Izhar","year":"2019","journal-title":"J. Pak. Med. Assoc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1093\/humrep\/dead150","article-title":"Evidence-based guideline: Unexplained infertility","volume":"38","author":"Romualdi","year":"2023","journal-title":"Hum. Reprod."},{"key":"ref_7","first-page":"283","article-title":"Comparison of Hystero-salpingography and Hysterosalpingo-Contrast Sonography for tubal patency testing: Technical success, pain perception, side effects and complications","volume":"23","author":"Maxim","year":"2021","journal-title":"Med. Ultrason."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1046\/j.1469-0705.2000.00327.x","article-title":"Three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy) as an outpatient procedure to assess infertile women: A pilot study","volume":"16","author":"Kiyokawa","year":"2000","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.ejogrb.2024.12.004","article-title":"Prevalence of contrast intravasation in HyCoSy\/HyFoSy. Results of a multicenter study and systematic review of the literature with meta-analysis","volume":"305","author":"Alcazar","year":"2025","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1093\/humrep\/deu024","article-title":"Hysterosalpingosonography for diagnosing tubal occlusion in subfertile women: A systematic review with meta-analysis","volume":"29","author":"Boutin","year":"2014","journal-title":"Hum. Reprod."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.7863\/jum.2009.28.12.1671","article-title":"Diagnostic value of sonohysterography in the determination of fallopian tube patency as an initial step of routine infertility assessment","volume":"28","author":"Hajishafiha","year":"2009","journal-title":"J. Ultrasound Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1034\/j.1600-0412.1998.771006.x","article-title":"Vaginal sonosalpingography in the evaluation of tubal patency","volume":"77","author":"Inki","year":"1998","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"236","DOI":"10.4103\/jhrs.JHRS_47_18","article-title":"Role of Saline Infusion Sonohysterography in Infertility Evaluation","volume":"11","author":"Singh","year":"2018","journal-title":"J. Hum. Reprod. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"683","DOI":"10.18203\/2320-1770.ijrcog20210327","article-title":"Assessment of tubal patency through sono-hysterosalpingography using B-mode and colour Doppler: A comparative study","volume":"10","author":"Gupta","year":"2021","journal-title":"Int. J. Reprod. Contracept. Obstet. Gynecol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"58","DOI":"10.4236\/ojmi.2019.94006","article-title":"Comparative Analysis of Saline Sonohysterosalpingography to Hysterosalpingography in the Diagnosis of Utero-Tubal Pathology amongst Infertile Women at the University of Port Harcourt Teaching Hospital","volume":"9","author":"Nnah","year":"2019","journal-title":"Open J. Med. Imaging"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"80","DOI":"10.36106\/ijar\/6009505","article-title":"A Study on the Role of Saline Sonosalpingography as a Test for Tubal Patency in the Assessment of Infertility","volume":"11","author":"Das","year":"2021","journal-title":"Indian J. Appl. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/S1074-3804(05)60264-2","article-title":"Hysterosalpingo-contrast sonography compared with hysterosalpingography and laparoscopic dye pertubation to evaluate tubal patency","volume":"10","author":"Exacoustos","year":"2003","journal-title":"J. Am. Assoc. Gynecol. Laparosc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1002\/jcu.23210","article-title":"The clinical application of ultrasonography with superb microvascular imaging-a review","volume":"50","author":"Tang","year":"2022","journal-title":"J. Clin. Ultrasound"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1002\/jcu.24046","article-title":"Assessing the Clinical Characteristics and the Role of Imaging Modalities in Uterine Sarcoma: A Single-Center Retrospective Study from Vietnam","volume":"53","author":"Nguyen","year":"2025","journal-title":"J. Clin. Ultrasound"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1002\/uog.5169","article-title":"Value of preoperative ultrasound examination in the selection of women with adnexal masses for laparoscopic surgery","volume":"30","author":"Yazbek","year":"2007","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"285","DOI":"10.5603\/GP.a2017.0054","article-title":"Usefulness of saline infusion sonohysterography and feeding artery imaging in endometrial polyp diagnosis","volume":"88","author":"Dec","year":"2017","journal-title":"Ginekol. Pol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/S0301-2115(01)00567-X","article-title":"Sonohysterography: A prospective survey of results and complications in 81 patients","volume":"102","author":"Bonnamy","year":"2002","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1148\/rg.2018180080","article-title":"Adenomyosis: A Sonographic Diagnosis","volume":"38","author":"Cunningham","year":"2018","journal-title":"Radiographics"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1111\/j.1479-828X.1997.tb02255.x","article-title":"Saline infusion sonohysterosalpingography, an underutilized technique","volume":"37","author":"Kuhn","year":"1997","journal-title":"Aust. N. Z. J. Obstet. Gynaecol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/9\/1287\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:10:43Z","timestamp":1777349443000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/9\/1287"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,24]]},"references-count":24,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["diagnostics16091287"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16091287","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,24]]}}}