Toufig Hind, Benameur Tarek, Twfieg Mohammed-Elfatih, Omer Hiba, El-Musharaf Tamara
College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia.
Department of Basic Sciences, Deanship of Preparatory Year, Imam Abdulrahman Bin Faisal University, Saudi Arabia.
Saudi J Biol Sci. 2020 Nov;27(11):2876-2882. doi: 10.1016/j.sjbs.2020.08.041. Epub 2020 Sep 2.
Infertility is a global health issue and hysterosalpingography (HSG) is a valuable radiological tool in infertility workup and remains a main modality for investigating female infertility. However, the HSG findings of infertility are not the same worldwide.This study aimed at evaluating the incidence of HSG findings in patients investigated for primary and secondary infertility, correlating these findings with their clinical data that reflect the infertility causes and comparing the findings with previous international studies.
A prospective descriptive study of 75 female patients referred, as cases of infertility, for HSG examination in Elrebat Hospital and Khartoum Advanced Diagnostic Center. HSG was performed in the first half of the cycle. The procedure and its complications, were explained to the patients and informed consents were obtained. Patients with active pelvic infection and active uterine or vaginal bleeding were excluded from the study. Using aseptic technique and with proper patient's positioning, iodinated contrast was introduced into the cervix under fluoroscopic monitoring, to demonstrate the uterine cavity, fallopian tubes and free spillage into the peritoneal cavity. Personal data, clinical data and HSG findings were analyzed using SPSS version 23.
The commonest age group seen was 26-36 years. Close incidences of primary and secondary infertility were detected. 52.7% had abnormal findings in HSG. Tubal pathology (42.7%) being the most common abnormality, followed by uterine and combined abnormalities. There was strong association between past medical history suggesting pelvic inflammatory disease (PID) or past history suggesting tubal blockage secondary to abdominopelvic surgery and tubal abnormalities.
HSG examinations revealed that the most common abnormality was tubal blockage possibly complicating PID and abdominopelvic surgeries. This reflects the HSG diagnostic and therapeutic role in the assessment of female infertility and the further needs for more preventive measures targeting the reduction of tubal pathologies in developing countries.
不孕症是一个全球性的健康问题，子宫输卵管造影（HSG）是不孕症检查中一种有价值的放射学工具，仍然是调查女性不孕症的主要方式。然而，不孕症的HSG检查结果在全球范围内并不相同。本研究旨在评估因原发性和继发性不孕症接受检查的患者中HSG检查结果的发生率，将这些结果与其反映不孕症病因的临床数据相关联，并将结果与以往的国际研究进行比较。
对75例因不孕症转诊至埃尔雷巴特医院和喀土穆高级诊断中心进行HSG检查的女性患者进行前瞻性描述性研究。HSG检查在月经周期的前半期进行。向患者解释了检查过程及其并发症，并获得了知情同意书。患有活动性盆腔感染以及活动性子宫或阴道出血的患者被排除在研究之外。采用无菌技术并在患者正确体位下，在荧光透视监测下将碘化造影剂注入宫颈，以显示子宫腔、输卵管以及造影剂向腹腔的自由溢出。使用SPSS 23版软件对个人数据、临床数据和HSG检查结果进行分析。
最常见的年龄组为26 - 36岁。原发性和继发性不孕症的发生率相近。52.7%的患者HSG检查结果异常。输卵管病变（42.7%）是最常见的异常情况，其次是子宫及合并异常。提示盆腔炎（PID）的既往病史或提示盆腔腹部手术后输卵管堵塞的既往病史与输卵管异常之间存在密切关联。
HSG检查显示，最常见的异常是输卵管堵塞，可能与PID及盆腔腹部手术有关。这反映了HSG在评估女性不孕症方面的诊断和治疗作用，以及发展中国家进一步需要采取更多预防措施以减少输卵管病变的必要性。
