{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T03:42:20Z","timestamp":1788925340721,"version":"build-2803163510"},"reference-count":28,"publisher":"Termedia Sp. z.o.o.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pol J Radiol"],"abstract":"\n Purpose<\/jats:title>\n Tubal patency examination is an essential part of the infertility workup; HyFoSy is a recommended substitute for the standard Hystero-Salpingo Graphy (HSG). This study aims to determine the diagnostic concordance of HyFoSy and HSG and to determine impact of uterus position on test performance.<\/jats:p>\n <\/jats:sec>\n \n Material and methods<\/jats:title>\n A prospective observational cohort study enrolled 80 infertile women referred for assessing tubal patency at Al Yarmouk Hospital.Parameters recorded: demographics ( age, parity, uterus position) and tubal patency test interpreted ( patent, unilateral, or bilateral blocked tubes). HyFoSy was performed first, followed by HSG.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Age and parity were insignificant. HyFoSy showed a high degree of diagnostic concordance with HSG ( 85%) with 0.3 (95% CI: 0.05\u20130.55) Cohen's kappa coefficient . Gwet's AC1 coefficient was 0.84 (95% CI: 0.74\u20130.94), indicating strong agreement. McNemar's test revealed significant systematic bias between the methods (P < 0.001), suggesting that HyFoSy and HSG are not interchangeable, which was further confirmed by Bland-Altman analysis showing a mean bias of +0.25 in favor of HyFoSy.The latter has a tendency to overestimate tubal patency among women with a retroverted uterus.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n HyFoSy is a promising tool to be used as a complementary infertility test showing high concordance with HSG. However, it should not be used as a stand-in for HSG without clinical judgment, especially in women with a retroverted uterus. The best of both approaches may be provided by a hybrid strategy that uses HyFoSy as a first-line test and saves HSG for cases that are unclear or high-risk.<\/jats:p>\n <\/jats:sec>","DOI":"10.5114\/pjr\/216144","type":"journal-article","created":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T11:36:14Z","timestamp":1778931374000},"page":"222-229","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic performance of HyFoSy versus HSG for tubal patency: accuracy and agreement analysis"],"prefix":"10.5114","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7029-0451","authenticated-orcid":true,"given":"Shaymaa K.","family":"Abdulqader","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wassan","family":"Nori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajaa A.","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wisam","family":"Akram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8964-8943","authenticated-orcid":true,"given":"Nabeeha N.","family":"Akram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3061","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"key":"ref-1864595","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2024.104380"},{"key":"ref-1864596","doi-asserted-by":"crossref","unstructured":"Tanaka K, Chua J, Cincotta R, Ballard EL, Duncombe G. 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