Abstract:
Background: The aim of this study was to determine the relevance of Hysterosalpingogram (HSG) in current infertility management and to highlight the shortcomings of Hysterosalpingography At the Rivers State University Teaching Hospital (RSUTH), Nigeria and sub-Saharan Africa. Methods: This was a retrospective, cross-sectional study of 200 Hysterosalpingogram results of patients that were being managed for infertility from 1st January 2020 to 31st December 2021 at the Rivers State University Teaching Hospital, Port Harcourt. The HSG was done at the Radiological Department of the hospital. Data was collected from the patient case notes and from the Radiological department of RSUTH. Data were analyzed using SPSS version 25. Quantitative data were represented as mean ± SD while qualitative ones were described as frequency and percentage.
Results: A total of 200 Hysterosalpingogram results of patients were analyzed. Their mean ±SD age was 33.5±5 years. The indication for HSG was infertility for all of them. Infertility duration was greater than one year for all of them. Sixty-two (31%) had primary infertility while 138 (69%) had secondary infertility. One hundred and three (51.5%) of the patients had significant previous gynecological and obstetric history that predisposed them to tubal factor infertility. HSG findings were bilateral tubal patency in 79 cases (39.5%), Hydrosalpinx/peritubal adhesions in 11(5.5%), unilateral tubal occlusion in 14 (7%), Bilateral tubal occlusion in 35(17.5%), and intra uterine adhesion in 50 (25%). Thus, HSG investigation was able to detect the likely cause of infertility in (60.5%) of the participants.
Conclusion: HSG is still the most common first-line diagnostic test to evaluate the uterine cavity and tubal pathology in infertility patients. Laparoscopy, Hysteroscopy, Transvaginal ultrasound scan, and Magnetic resonance imaging are more reliable methods of detecting tubal pathology or uterine cavity anomalies in infertility evaluation. These are not easily available in low -and -middle-income countries, especially sub-Saharan Africa and Nigeria in particular because of cost. HSG is relatively cheap and uncomplicated, which has contributed to it acquiring a primary role in assessing abnormal findings in fallopian tubes and uterine cavity.
