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Title: A Comparison of Hysterosalpingographic Results in Individuals Experiencing Primary and Secondary Infertility: A Prospective Approach
Authors: Naushaba Malik, Hinna Hanif Mughal, Hassan Mumtaz, Shahbakht Aftab, Minaal Ahmed Khan, Saima Bibi, Rida Noor
Journal: Journal of Islamabad Medical and Dental College (JIMDC)
Publisher: Healers Educational Society
Country: Pakistan
Year: 2023
Volume: 12
Issue: 4
Language: English
DOI: 10.35787/jimdc.v12i4.1053
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
 
 
To compare the Hysterosalpingographic (HSG) results in a study population experiencing primary and secondary infertility.
A one-year prospective study conducted at Islamabad Diagnostic Center, Pakistan. Institutional review board approval was obtained. Sample size was calculated using "Raosoft" software (n=242). Patients with primary and secondary infertility who provided informed consent were enrolled. Demographics (age, duration of infertility) and tubal/uterine abnormalities were collected from clinical notes and X-ray findings. The study included women aged 20-45 with 1-15 years of infertility and regular menstrual cycles. Exclusions included major uterine/fallopian tube surgery, inconclusive results, and non-infertility examinations. HSG procedures were performed 7-10 days post-menstruation. Data was analyzed using SPSS version 24, with descriptive statistics (frequency, mean, percentage) and chi-square test for significant differences (P < 0.05).
graph TD
A["Obtain IRB Approval"] --> B["Recruit Patients with Primary/Secondary Infertility"];
B --> C["Collect Demographics & Clinical Data"];
C --> D["Perform Hysterosalpingography HSG"];
D --> E["Analyze X-ray Findings"];
E --> F["Statistical Analysis SPSS v24"];
F --> G["Compare HSG Results for Primary vs. Secondary Infertility"];
G --> H["Draw Conclusions & Implications"];
Infertility is a significant healthcare issue, particularly in developing countries. The study highlights that fallopian tube abnormalities are the most common factor in infertile women. The findings suggest that proactive measures and effective management of pelvic infections are crucial for reducing infertility stemming from tubal issues. HSG remains a valuable, accessible, and cost-effective tool for diagnosing infertility. The study also noted that the prevalence of primary and secondary infertility and their association with age varied compared to previous studies.
- Primary infertility was observed in 70.27% (n=170) and secondary infertility in 29.75% (n=72) of the 242 enrolled patients.
- Fallopian tube blockage was the most common abnormality in both groups: 20.00% (n=34/170) in primary infertility and 30.55% (n=22/72) in secondary infertility.
- Among primary infertility patients with tubal blockage, 26.47% had unilateral blockage and 29.41% had bilateral blockage. Bilateral hydrosalpinx affected 23.52%.
- 80.0% of primary infertility patients and 69.44% of secondary infertility patients had normal HSG results.
- Uterine abnormalities were more prevalent in secondary infertility patients.
Hysterosalpingography (HSG) is a commonly used technique to assess uterine and fallopian tube health in infertile women. Fallopian tube abnormalities were the most predominant factor identified in infertile women in this study. Therefore, preventative actions and effective management of pelvic infections are essential to mitigate infertility caused by tubal issues.
- The study enrolled 242 patients.
- Primary infertility was found in 70.27% of patients.
- Fallopian tube blockage was observed in 20.00% of patients with primary infertility.
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