Hysterosalpingographic findings in infertility - what has changed over the years?

Afr Health Sci. 2019 Jun;19(2):1866-1874. doi: 10.4314/ahs.v19i2.9.

Abstract

Background: Prior studies on Hysterosalpingography (HSG) have shown that pelvic inflammatory disease (PID) related tubal adhesions accounted for 30 - 50% of female infertility, with as high as 80% reported in some studies. With improved access to contraceptives, antibiotics and promotion of safe practices, the abnormal findings in HSG may have reduced or altered.

Objective: To document the imaging findings in the HSG of participants and to compare current findings with prior studies done nationally and internationally.

Method: A retrospective evaluation of 974 HSGs done at the tertiary diagnostic center over a 7-year period was conducted and analyzed using diagnostic accuracy tables.

Results: Tubal pathologies were the most common abnormality in this study, (35.1% of the cases), comprising tubal blockage and hydrosalpinges; followed by uterine masses seen in 223 (22.9%) of the clients. Tubal occlusion was higher in clients with multiple abnormal findings; while normal sized and large uterine cavities had a higher percentage of bilateral tubal patency.

Conclusion: Tubal factors remain the most common abnormality seen in the HSGs of infertile women in this study, though with lower prevalence compared with prior older studies. Forty seven (47%) of the cases of female factor infertility had normal HSGs with bilateral tubal patency.

Keywords: Africa; HSG; female; infertility; tubal factors; uterine masses.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Fallopian Tube Diseases / complications
  • Fallopian Tube Diseases / diagnostic imaging*
  • Fallopian Tube Diseases / epidemiology
  • Fallopian Tubes / diagnostic imaging*
  • Female
  • Humans
  • Hysterosalpingography / methods*
  • Infertility, Female / diagnostic imaging*
  • Infertility, Female / epidemiology
  • Infertility, Female / etiology
  • Retrospective Studies
  • Socioeconomic Factors
  • Uterus / diagnostic imaging*
  • Young Adult