Intrauterine adhesions, peritubal adhesions and tubal occlusion on hysterosalpingography

Abstract

Pelvic Inflammatory Disease (PID), Dilatation and Curettage (D&C) and other abdominopelvic surgeries are often presumed to cause female infertility. This can occur through adhesions formation that can result in Intrauterine Adhesions (IUA), Peritubal Adhesions (PTA) and Tubal Occlusion (TO). Hysterosalpingography (HSG) can be used to diagnose IUA, PTA, and TO; and the correlations of these findings with the histories of PID, D&C and other abdominopelvic surgeries statistically tested. The available literature shows very few of such correlation tests. The objective of this study was to document HSG diagnosis of IUA, PTA and TO, and test their correlation with histories of previous PID, D&C and abdominopelvic surgeries among women with secondary infertility. This is a prospective descriptive study of 158 subjects, analyzed with SPSS version 21. For correlation test, p≤0.05 is considered significant. There was history of previous PID in 53 subjects (33.5%), D&C in 114 (72.2%), and abdominopelvic surgery in 80 (50.6%). The important findings included: IUA in 20 subjects (12.7%), TO in 53 (33.5%) and PTA in 30 (19.0%). Significant correlation was found between D&C and PTA, but not between PID and IUA, PID and TO, PID and PTA, D&C and IUA, D&C and TO, abdominopelvic surgery and IUA, abdominopelvic surgery and TO, or abdominopelvic surgery and PTA. Tubal occlusion, followed by PTA and by IUA were detected in that order as the possible causes of infertility in our subjects; and these did not correlate well with the history of PID, D&C and other abdominopelvic surgeries.