Hysterosalpingography Findings Among Infertile Women in A Tertiary Health Facility in Northwest Nigeria

Background: Infertility is a global health problem with a high prevalence in low- and middle-income countries, particularly Sub-Saharan Africa, where infection-related tubal damage is the leading cause. Hysterosalpingography (HSG) is the first-line imaging modality for assessing tubal patency in the evaluation of female infertility. This study aimed to determine the prevalence and spectrum of HSG findings among infertile women referred to the radiology department of Sir Yahaya Memorial Hospital, Birnin Kebbi, Nigeria. Methods: This was a cross-sectional prospective study involving 300 infertile women aged 18 – 48 years who underwent HSG at a tertiary healthcare facility. Patient demographics and HSG findings were analyzed. Results: Out of the three hundred participants, one hundred and seventy-five (58.3%) patients had abnormal HSG findings while one hundred and twenty-five (41.7%) had normal findings. Tubal abnormalities were seen in eighty-nine (29.7%) with bilateral proximal tubal occlusion been the commonest abnormality comprising of 10% of the total tubal abnormalities. Bilateral distal tubal occlusion was seen in only 1% of the total number of patients. Seventeen (5.7%) had only right tubal occlusion while eight (2.6%) had only left tubal occlusion. Other abnormalities include: hydrosalpinx (n = 28; 9.4%), uterine fibroids (n = 35; 11.7%), cervico-uterine adhesions (n = 20; 6.7%), pelvic adhesions (n = 17; 5.7%), endometrial hyperplasia (n = 3; 1%) and congenital anomalies (n = 11; 3.7%). Conclusion: Bilateral proximal tubal occlusion was the most common hysterosalpingographic finding among women with infertility at Sir Yahaya Memorial Hospital, Birnin Kebbi. Sexually transmitted diseases, as well as post-abortal and postpartum infections, are major contributors to the high rate of tubal pathologies. Prompt diagnosis and treatment of these preventable reproductive tract infections would significantly reduce high prevalence of infertility in our environment.