Hysterosalpingography Findings among Women Undergoing Infertility Workup at St. Paul’s Hospital Millennium Medical College Addis Ababa, Ethiopia: A One Year Patients’ Chart Review
Abstract
Background: Infertility is a major public health concern in several African countries. The primary investigation modalities for female infertility used widely today is hysterosalpingography, a radiographic technique for evaluating the uterine cavity and fallopian tubes patency. Hysterosalpingography is an easy, relatively safe, and cheap diagnostic modality. Despite its frequent utilization in the country, there are only limited studies in the Ethiopian context regarding the patterns of hysterosalpingography findings. This study is intended to determine the predominance of various hysterosalpingography results in patients that went through infertility work-up at SPHMMC between March 1st, 2019, and February 29th, 2020.
Methods: Hospital-based cross-sectional study was done on infertile women who had infertility workup in SPHMMC between March 1st, 2019, and February 29th, 2020 by reviewing their medical charts. The charts were selected via simple random sampling technique .Descriptive analysis was employed to determine the pattern of hysterosalpingography findings and chi-square and multivariate logistic regression analyses were used to identify factors associated with it. Variables with a p-value <0.05 were taken as statistically significant factors.
Result: This study shows that 57% of infertile women had abnormal hysterosalpingography findings in the cervix, uterus, and fallopian tubes or more than one of the structures. The tubal finding was the most frequently noted structural abnormality (45%) in which 70.23% of who were bilateral. HSG findings with tubal abnormality had a statistically significant association with history TB treatments with a p-value of 0.000, OR 4. 2(95% CI 2.3-9), and with a history of gynecologic surgery which has also a P value of 0.007, OR 2.7(95%CI 1.34 -5.56). Asherman syndrome, peritubal adhesion, and hydrosalpinx were detected in 4.8, 4.1and 4.1% of hysterosalpingography study respectively.
Conclusion: There was a high incidence of tubal disease in the women presenting with infertility. This study highlighted that HSG is a very useful modality in detecting female genital tract abnormality in infertile women. Hence this important diagnostic procedure should be made available in SPHMMC for adequate assessment of the women with infertility, where almost all procedures have taken place at a private health facility.