Hysterosalpigography findings of female partners of infertile couple attending fertility clinic at Lagos University Teaching Hospital

Abstract

Introduction Hysterosalpingography (HSG) is an outpatient fluoroscopic method for the evaluation of the uterine cavity, fallopian tubes, and the surrounding peritoneal cavity. Female fertility depends greatly on normal female reproductive organs; hence tubal abnormalities may contribute significantly to female infertility. HSG is an invaluable screening tool in the evaluation of women with suspected tubal factor infertility. This study aims to review the HSG findings of women who sought fertility treatment at the Lagos University Teaching Hospital, Lagos (LUTH). Methods this was a retrospective study of the pattern of HSG findings among female partners of infertile couples seeking fertility treatment at the LUTH, over a 2-year period, from January 2018 to December 2019. Results a total of 266 medical records and HSG results were reviewed and included in the data analysis. The mean age (± standard deviation) was 38.4 (± 0.3) years with a range of 24 to 50 years. Most (80.5%) of the participants have secondary infertility and majority (65.4%) were nulliparous. Tubal pathology was the commonest abnormality detected on HSG in 54.9% of women. About one-third (30.8%) of women had bilateral tubal occlusion on HSG. With regards to the right fallopian tube, 43.2% of the participants had tubal occlusion, which differs from 41.7% on the left fallopian tube. Similarly, 10.2% of the women had hydrosalpinx on the left tube when compared with 9% on the right tube. Age (OR 1.055; 95% CI: 1.006, 1.106, p-value 0.028), and previous salpingectomy [OR 6.151; 95% CI: 1.335, 28.349] and myomectomy [OR 4.6; 95% CI: 1.814, 11.67] were identified as risk factors for tubal pathologies on HSG. Conclusion tubal abnormalities are common findings on HSG and the identifiable risk factors for tubal pathologies include age, salpingectomy, and myomectomy. HSG remains a vital screening tool in the evaluation of tubal-factor infertility in Nigeria.

Hysterosalpingography Findings among Women Presenting for Infertility Evaluation in Bayelsa State, South-South Nigeria

“…Secondary infertility was the most common cause of infertility in this study. This is in tandem with the reports from many studies [16,20,21]. The plausible reason for this observation may be due to post-abortion sepsis and pelvic inflammatory disease that may have arisen from induced abortion, as observed in our study.…”

“…Bilateral tubal blockade was seen in 31.1% of the women. This is similar to 30.8% reported by Makwe et al [20] in Lagos. It is higher than 4 -25.4% reported by previous studies [14][15][16]22,24].…”

“…This was in tandem with the observation in some studies [15,16,25]. However, the preponderance of left hydrosalpinx was reported in some other studies [20,26,27]. The reason for this difference is not clear.…”

“…Lower value of 16.6% have been reported in Kampala, Uganda [23]. Our value was lower than the 45.2% reported by Olatunji et al [16] in Ogun State, Nigeria; 34.6% by Makwe et al [20] in Lagos, Nigeria; and 62% by Gul et al, in Quetta, Pakistan [24]. The reason for these differences is not readily understood.…”

“…Peritubal adhesions were seen in 4.5% of the women. Some other studies have reported similar finding [14,20,21]. Peritubal adhesions may result from post-operative adhesions, endometriosis or previous poorly managed pelvic inflammatory disease.…”