159 Cochrane study protocol: Accuracy of tubal patency tests 7 The choice of visual tubal patency tests also varies in different settings, depending on the preference and skills of the clinician, the preference of the couples with infertility and the availability of tubal testing methods in the clinic. In different geographical and economic contexts, costs, availability and the accessibility of these testing methods will differ. However, if available and accessible, this protocol hopes to answer the question of which visual tubal patency test should be advised above others as a replacement test for laparoscopy to diagnose tubal patency. Alternative test(s) Alternative tests are not applicable, as all visual tubal patency tests will be reviewed in this protocol. Rationale Over the last two decades, new tubal patency tests (e.g. MR‐HSG) have been emerging, as well as new contrast media or test technology for existing tubal patency tests. Therefore, it is important to summarise all the evidence on the accuracy of individual tests, and to compare different tests’ accuracies. However, there is no Cochrane Review on this topic. As visual tubal patency tests are all less invasive than diagnostic laparoscopy and are well‐tolerated in an outpatient setting, it seems fair to offer such a test instead of the reference standard diagnostic laparoscopy. Nevertheless, the diagnostic accuracy of these tests is less acknowledged in clinical decision‐making about the choice of tubal testing method. Currently, there is no consensus in terms of how different types of visual tubal patency test compare to each other. Before replacing the reference standard, it is important to understand the diagnostic accuracy of each individual visual patency test and to compare the diagnostic accuracy when possible. Couples with infertility will benefit from this research as it will guide clinicians to select the most suitable visual tubal patency test for the individual couple. OBJECTIVES To determine and compare the diagnostic accuracy of visual tubal patency tests (hysterosalpingography (HSG), sono‐hysterosalpingography (sono‐HSG), magnetic resonance hysterosalpingography (MR‐HSG), and outpatient transvaginal hydrolaparoscopy (THL)) for the diagnosis of tubal occlusion. Secondary objectives To determine and compare the diagnostic accuracy of visual tubal patency tests (HSG, sono‐HSG, MR‐HSG, and outpatient THL) for the diagnosis of hydrosalpinx.
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