Hysterosalpingography Findings among Women Presenting for Infertility Evaluation in Bayelsa State, South-South Nigeria

Background: Hysterosalpingography is an investigative modality used in the evaluation of the uterine cavity, fallopian tubes, and adjacent peritoneal cavity following the injection of contrast material through the cervical canal.

Objective: To determine the pattern of pathologies seen in infertile women undergoing hysterosalpingography.

Materials and Methods: This prospective research was conducted at the Obstetrics and Gynaecology, and Radiology Departments of the two tertiary health institutions in Bayelsa State, Nigeria, from January to July, 2021. Hysterosalpingography was done for 350 infertile women, after obtaining written informed consent. Data were entered into a pre-designed proforma, and analysed using Statistical Product and Service Solutions (SPSS) version 25.0. Results were presented in frequencies and percentages for categorical variables, and mean and standard deviation for continuous variables.

Results: The most common tubal finding was blockage; 7 in 10 (71.7%) women had at least one blocked tube. One hundred and nine (31.1%) had both tubes blocked, the left tube was blocked in seventy-nine (22.6%), while the right tube was affected in sixty-three (18.0%) women. Hydrosalpinx affected the right, left and both tubes in 20 (5.7%), 8 (2.3%) and 4 (1.1%) women respectively. Uterine findings were fibroids (21.1%), intrauterine adhesion (3.4%) bicornuate uterus (0.9%) and adenomyosis (1.1%).

Conclusion: This study revealed a high incidence of tubal blockage in the women being evaluated for infertility. The plausible reason for this observation may be due to post-abortion sepsis and pelvic inflammatory disease that may have arisen from induced abortion, as observed in our study. Hysterosalpingography remains a very crucial investigative modality that plays a central role in the evaluation of infertile women.