Evaluation of hysterosalpingographic findings among patients presenting with infertility

Infertility is a global health issue and hysterosalpingography (HSG) is a valuable radiological tool in infertility workup and remains a main modality for investigating female infertility. However, the HSG findings of infertility are not the same worldwide.This study aimed at evaluating the incidence of HSG findings in patients investigated for primary and secondary infertility, correlating these findings with their clinical data that reflect the infertility causes and comparing the findings with previous international studies.

A prospective descriptive study of 75 female patients referred, as cases of infertility, for HSG examination in Elrebat Hospital and Khartoum Advanced Diagnostic Center. HSG was performed in the first half of the cycle. The procedure and its complications, were explained to the patients and informed consents were obtained. Patients with active pelvic infection and active uterine or vaginal bleeding were excluded from the study. Using aseptic technique and with proper patient's positioning, iodinated contrast was introduced into the cervix under fluoroscopic monitoring, to demonstrate the uterine cavity, fallopian tubes and free spillage into the peritoneal cavity. Personal data, clinical data and HSG findings were analyzed using SPSS version 23.

The commonest age group seen was 26-36 years. Close incidences of primary and secondary infertility were detected. 52.7% had abnormal findings in HSG. Tubal pathology (42.7%) being the most common abnormality, followed by uterine and combined abnormalities. There was strong association between past medical history suggesting pelvic inflammatory disease (PID) or past history suggesting tubal blockage secondary to abdominopelvic surgery and tubal abnormalities.

HSG examinations revealed that the most common abnormality was tubal blockage possibly complicating PID and abdominopelvic surgeries. This reflects the HSG diagnostic and therapeutic role in the assessment of female infertility and the further needs for more preventive measures targeting the reduction of tubal pathologies in developing countries.