A Comparison of Hysterosalpingographic Results in Individuals Experiencing Primary and Secondary Infertility: A Prospective Approach

Abstract

Introduction: In order to examine the uterine and fallopian tubes in women suffering from infertility, Hysterosalpingography (HSG) technique is commonly used in process of different investigations. The technique is used to assess any blockages in the tubes or normal morphology of the uterus. This study aims to compare the HSG results in a study population having primary and secondary infertility.

Materials and Methods: We conceded a one-year prospective study at Islamabad Diagnostic Center in Islamabad, Pakistan after getting institutional review board approval. The study duration was from July 1, 2022 to June 30, 2023. Sample size was calculated using online software “Raosoft” which estimated it to 242. All the patients who gave informed consent and having primary and secondary infertility were enrolled. Demographics of the patients including age, duration of infertility, and the presence of tubal and uterine abnormalities, were collected by reviewing clinical notes and X-ray findings.

Results: Among 242 enrolled patients with infertility, the ratio of primary infertility was 70.27% (n=170) and that of secondary infertility was 29.75% (n=72). In both the groups, fallopian tube blockage was observed as a major abnormality that affected 20.00% (n=34/170) of patients with primary infertility and 30.55% (n=22/72) of patients with secondary infertility. Unilateral tube blockage was observed in 26.47% (n=9/34) whereas, bilateral blockage was observed in 29.41% (n=10/34) patients with primary infertility. 23.52% (n=8/34) of patients got affected with Bilateral hydrosalpinx, whereas unilateral loculated spill was perceived in 8.82% (n=3/34) of. In patients with uterine congenital abnormalities, 5.88% (n=2/34) had a bicornuate uterus, 2.94% (n=1/34) had a unicornuate uterus, and 2.94% (n=1/34) had uterine didelphys.

Conclusion: In order to examine the uterine and fallopian tubes in women suffering from infertility, Hysterosalpingography (HSG) technique is commonly used. The technique is used to assess any blockages in the tubes or normal morphology of the uterus. In this study, fallopian tube abnormalities were most predominant among barren women. So, taking deterrent actions and efficiently management of pelvic infections are indispensable in plummeting the manifestation of infertility resultant of the tubal issues.

Keywords: Hysterosalpingography, Infertility, Subfertility, Tubal blockage