Evaluation of pattern of tubo-peritoneal abnormalities potentially responsible for infertility in Zaria, Nigeria: hysterosalpingographic assessment

Abstract

Background: Structural abnormalities on hysterosalpingography (HSG) are among the important factors in the evaluation of female infertility. Aim and Objective: This study is mainly concerned with the pattern of tubal and peritoneal abnormalities and their effects on fertility outcome. Materials and Methods: A prospective study of 220 consecutive patients who underwent HSG between December, 2011 and May, 2013, at Department of Radiology, Ahmadu Bello University Teaching Hospital, Zaria. Clinical notes and radiological findings were analyzed for demographic data, tubal and peritoneal pathologies. Fertility outcome in patients with abnormal findings was compared with those with normal findings. Results: A total of 121 (55.0%) patients had normal tubes on HSG. Tube abnormalities were found in 99 (45.0%) patients; 37 (37%) patients with primary and 62 (63%) patients with secondary infertility. Totally, 203 (92.3%) patients had normal peritonea contrast medium spillage on HSG. Peritoneal cavity abnormality (pelvic adhesion) affected 17 (7.7%) patients; 8 (47%) patients with primary and 9 (53%) patients with secondary infertility. The fertility outcome showed that after 1-year of follow-up, 3 (2.6%) of the 116 patients with abnormal findings (tubal and peritoneal abnormalities) got pregnant, while 25 (34.7%) of the 72 patients with normal findings (tubal, peritoneum, cervical canal and endometrial cavity) got pregnant. The difference noted was statistically significant (P = 0.0000). Conclusion: Fertility outcome in patients with tubo-peritoneal abnormalities at HSG was low.