Role of hysterosalpingography as a simple tool in the diagnosis of uterotubal causes of infertility in a developing country setting

Abstract

The objective of the study was to evaluate the role of hysterosalpingography in the diagnosis of utero-tubal causes of infertility.
All hysterosalpingograms taken for infertility from July 2000 to June 2001 at the Federal Medical Centre Gombe were analysed for utero-tubal and pelvic pathologies as seen on radiological examination. One hundred and forty one hysterosalpingogramswere reviewed for cervical, uterine, tubal and pelvic pathologies. In 100 (70.9%), the HSG was able to detect some abnormality. The abnormalities were usually multiple. Synaechiae accounted for 28.4% and 19.9% of cervical and uterine pathologies respectively, followed by uterine fibroids in 9.2% of cases. In 38.3% of cases, the tubes were blocked with the cornua being the commonest site of blockage. There was a 4:1 ratio between right-sided and left-sided distal tubal block, with equal cornual involvement on both sides. Therewere 10 (7.1%) cases of hydrosalpinges. Twenty patients (14.2%) had dye loculation in the pelvis, suggestive of pelvic adhesions, mainly perifimbrial. There were statistically significant associations between cervical and uterine synaechiae, and between uterine synaechiae, uterine fibroids and tubal block. Hysterosalpingography remains an important and invaluable tool in defining utero-tubal causes of infertility. Hysteroscopy and laparoscopy are recommended to complement HSG in further evaluating uterine synaechiae and pelvic adhesions respectively, considering their high prevalence.

Keywords: Hysterosalpingography, utero-tubal, infertility.