Comparison of the relevance of hysterosalpingography and ultrasonography in the management of infertility among women of reproductive age in Rivers State, Nigeria

Studies have shown that women of childbearing age in sub-Saharan Africa who desire to have children are facing higher rates of secondary infertility compared to the global average. This study aims to evaluate the significance of hysterosalpingography (HSG) and ultrasonography (US) in the treatment of infertility among women of reproductive age in Rivers State, Nigeria, by examining the findings from HSG and US regarding the myometrium, endometrium, ovaries, and fallopian tubes of the participants. The study used a Mindray ultrasound machines, with transducers (probes) operating at frequencies of 3.5 MHz - 7 MHz and 5-12 MHz (3C5A and L13-3), along with ultrasound gel. Data analysis was conducted using Microsoft Excel version 16 and SPSS (Statistical Package for the Social Sciences) version 22. The findings related to the endometrium indicate a moderate level of agreement between US and HSG. The discrepancies primarily occurred in instances where US identified focal intracavitary lesions that were not clearly visible on HSG, or where HSG indicated an irregular cavity contour without a corresponding discrete correlate on US. Additionally, myometrium findings demonstrated a fair to moderate level of agreement. US was found to be superior in identifying leiomyomas and features indicative of adenomyosis, while HSG only revealed abnormalities indirectly when the uterine cavity was distorted. The ovarian findings showed a poor level of agreement between US and HSG. US, particularly transvaginal ultrasound, effectively visualized ovarian morphology and detected functional cysts or masses, whereas HSG had minimal diagnostic value for ovarian pathology. There was a significant level of agreement between both imaging modalities in assessing fallopian tube patency or blockage, with HSG remaining the gold standard for evaluating tubal patency. In summary, US offered a more comprehensive evaluation of the endometrium, myometrium, and ovaries, while HSG proved to be the most effective for assessing fallopian tube patency. The complementary functions