Abstract: Objective To investigate the value of four-dimensional ultrasound hysterosalpingogram (4D-HyCoSY) in the evaluation of female infertility. 
Methods A total of 90 female patients with suspected tubal infertility admitted to our hospital were selected as the research subjects. All patients underwent 4D-HyCoSY, hysterosalpingography (HSG) and laparoscopy, respectively. In the meantime, with the results of laparoscopy as the gold standard, the value of HSG, 4D-HyCoSy and their combination in the diagnosis of female infertility was determined by consistency analysis. 
Results There was no significant difference in tubal patency between different methods (P> 0.05). The consistency analysis confirmed that the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of HSG in the evaluation of female infertility were 0.680, 1.000, 0.822, 1.000 and 0.714, respectively(Kappa=0.654). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 4D-HyCoSy in the evaluation of female infertility were 0.720, 1.000, 0.844, 1.000, and 0.741, respectively (Kappa=0.696), and the diagnostic sensitivity, accuracy and Kappa value of 4D-HyCosy were higher than those of HSG. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the two methods were 0.760, 1.000, 0.867, 1.000 and 0.769, respectively(Kappa=0.738). 
Conclusion The diagnostic sensitivity of 4D-HyCoSy for female tubal infertility is high, and the combined diagnosis of HSG and 4D-HyCOSY has a higher value, which is worthy of application. 

Key words: infertility, female, hysterosalpingography, laparoscopy