Study of HSG findings in our clientele: a multicentre retrospective analytical study

Authors

  • Shahla Yazdani Department of Obstetrics and Gynaecology, Command Hospital Air Force, Bangalore, Karnataka, India
  • Deepak Patil Department of Obstetrics and Gynaecology, Command Hospital Air Force, Bangalore, Karnataka, India
  • Sujoy Mitra Department of Obstetrics and Gynaecology, Command Hospital Air Force, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20220561

Keywords:

Fallopian tubes, Bicornuate uterus, HSG, Infertility

Abstract

Background: Infertility is a social morbidity for an infertile couple. The treatment is exhaustive and expensive.

Methods: Hysterosalpingography is a basic investigation for an infertile lady. We assessed the findings and outcome of HSG over one year at our tertiary care centers.

Results: Bilateral patent fallopian tubes and normal uterine cavity were the commonest finding. Pain was the commonest complication in the procedure. Going for diagnostic hystero-laparoscopic was the commonest surgical intervention following HSG. Starting ATT was the commonest medicine intervention. ART Treatment involved starting intrauterine insemination cycle following HSG. Spontaneous conception was a welcome outcome in a selected subset of patients.

Conclusions: HSG is an inexpensive and OPD based investigative modality. It is effective test for evaluation of infertility especially in low-resource settings. It is a stepping stone to guide further treatment in an infertile couple. A well timed and well exposed film can give numerous insights about the options for cure of this morbidity.

References

Borght MV , Wyns C. Fertility and infertility: Definition and epidemiology Clin Biochem. 2018; 62:2-10.

Rindfleisch W. Darstellung des cavum uteri. Klin Wochenscher. 1910;47:780.

Ludwin A, Ludwin I, Banas T, Knafel A, Miedzyblocki M, Basta A. Diagnostic accuracy of sonohysterography, hysterosalpingography and diagnostic hysteroscopy in diagnosis of arcuate, septate and bicornuate uterus. J Obstet Gynaecol Res. 2011;37(3):178-86.

Simpson WL , Beitia LG, Mester J. Hysterosalpingography: a reemerging study Radiographics. 2006;26(2):419-31.

Tsuji I, Ami K, Miyazaki A, Hujinami N, Hoshiai H. Benefit of diagnostic laparoscopy for patients with unexplained infertility and normal hysterosalpingography findings. Tohoku J Exp Med. 2009;219(1):39-42.

Renbaum L, Ufberg D, Sammel M, Zhou L, Jabara S, Barnhart K. Reliability of clinicians versus radiologists for detecting abnormalities on hysterosalpingogram films. Fertil Steril. 2002; 78(3):614-8.

Thangappah RB, Paramasivan CN, Narayanan S. Evaluating PCR, culture & histopathology in the diagnosis of female genital tuberculosis. Indian J Med Res. 2011;134(1):40-6.

Yang X, Zhu L, Le F, Lou H, Zhao W, Pan P, Zou Y, Jin F. Proximal fallopian tubal embolization by interventional radiology prior to embryo transfer in infertile patients with hydrosalpinx: a prospective study of an off-label treatment. J Minim Invasive Gynecol. 2020;27(1):107-15.

Zeyneloglu HB. Hydrosalpinx and assisted reproduction: options and rationale for treatment. Curr Opin Obstet Gynecol. 2001;13(3):281-6.

Kochorova MN, Semenovskiĭ AV. Features of hysterosalpingogram in verified genital tuberculosis. Probl Tuberk. 2001;(2):31-3.

Sierra S, McComb PF. Hysterosalpingography in the investigation of women requesting reversal of sterilization. Should it play a role? J Reprod Med. 2008;53(1):20-4.

Kitilla T. Tubo-peritoneal infertility: comparision of pre-operative hysterosalpingography and laparotomy findings (Tikur Anbessa Hospital, 1995 - 2002). Ethiop Med J. 2006;44(2):167-74.

Lin MH, Hwu YM, Lin SY, Lee RK. Treatment of infertile women with unilateral tubal occlusion by intrauterine insemination and ovarian stimulation. Taiwan J Obstet Gynecol. 2013;52(3):360-4.

Farhi J, Ben-Haroush A, Lande Y, Fisch B. Role of treatment with ovarian stimulation and intrauterine insemination in women with unilateral tubal occlusion diagnosed by hysterosalpingography. Fertil Steril. 2007;88(2):396-400.

Afzali N, Ahmadi F, Akhbari F. Various hysterosalpingography findings of female genital tuberculosis: A case series. Iran J Reprod Med. 2013; 11(6):519-524.

Shah SM, Towobola OA, Masihleho M. Diagnosis of fallopian tube patency. East Afr Med J. 2005; 82(9):457-62.

Onwuchekwa CR, Oriji VK. Hysterosalpingographic (HSG) Pattern of Infertility in Women of Reproductive Age. J Hum Reprod Sci. 2017;10(3): 178-84.

Golan A, Eilat E, Ron-El R, Herman A, Soffer Y, Bukovsky I. Hysteroscopy is superior to hysterosalpingography in infertility investigation. Acta Obstet Gynecol Scand. 1996;75(7):654-6.

Poonam A. The role of hysterosalpingography in cases of subfertility Kathmandu. Univ Med J. 2007;5(4):456-60.

Saravelos SH , Cocksedge KA, Li T-C. Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Hum Reprod Update. 2008;14(5):415-29.

Dusak A, Soydinc HE, Onder H, et al. Venous intravasation as a complication and potential pitfall during hysterosalpingography: re-emerging study with a novel classification. J Clin Imaging Sci. 2013; 3:67.

Dreisler E, Kjer JJ. Asherman's syndrome: current perspectives on diagnosis and management. Int J Womens Health. 2019 Mar 20;11:191-98.

Guvenc G, Bektas Pardes B, Kinci MF, Karasahin KE. Effect of education and counselling on reducing pain and anxiety in women undergoing hysterosalpingography: A randomised controlled trial. J Clin Nurs. 2020;29(9-10):1653-61.

Bastu E, Celik C, Nehir A, Dogan M, Yuksel B, Ergun B. Cervical priming before diagnostic operative hysteroscopy in infertile women: a randomized, double-blind, controlled comparison of 2 vaginal misoprostol doses. Int Surg. 2013;98(2):140-4.

Sohail S. Variables affecting immediate pain tolerance in X-ray hysterosalpingography. J Coll Physicians Surg Pak. 2004;14(3):170-2.

Møller BR, Allen J, Toft B, Hansen KB, Taylor-Robinson D. Pelvic inflammatory disease after hysterosalpingography associated with Chlamydia trachomatis and Mycoplasma hominis. Br J Obstet Gynaecol. 1984;91(12):1181-7.

Daňková Kučerová J, Machač Š, Vrzáčková P, Klapilová K, Kovář P, Zábranská L, Damborská Z, Wiecek P, Vrána T. Vaginismus - who takes interest in it? Ceska Gynekol. 2019;84(3):233-9.

Mondal SK. Histopathologic analysis of female genital tuberculosis: a fifteen-year retrospective study of 110 cases in eastern India. Turk Patoloji Derg. 2013;29(1):41-5.

Shah HU, Sannananja B, Baheti AD, Udare AS, Badhe PV. Hysterosalpingography and ultrasonography findings of female genital tuberculosis. Diagn Interv Radiol. 2015;21(1):10-5

Ishrat S, Fatima P. Genital tuberculosis in the infertile women - an update. Mymensingh Med J. 2015;24(1): 215-20.

Farrokh D, Layegh P, Afzalaghaee M, Mohammadi M, Fallah Rastegar Y. Hysterosalpingographic findings in women with genital tuberculosis. Iran J Reprod Med. 2015;13(5):297-304.

Chavhan GB, Hira P, Rathod K, Zacharia TT, Chawla A, Badhe P, Parmar H. Female genital tuberculosis: hysterosalpingographic appearances. Br J Radiol. 2004;77(914):164-9.

Tanahatoe S, Lambalk C, McDonnell J, Dekker J, Mijatovic V, Hompes P. Diagnostic laparoscopy is needed after abnormal hysterosalpingography to prevent over-treatment with IVF. Reprod Biomed Online. 2008;16(3):410-5.

Mohammadbeigi R, Tanhaeivash R. Comparison of hysterosalpingography and laparoscopy in infertile Iranian women with tubal factor. Ginekol Pol. 2012 Nov;83(11):841-3.

Tanos V, Berry KE, Seikkula J, Abi Raad E, Stavroulis A, Sleiman Z, Campo R, Gordts S. The management of polyps in female reproductive organs. Int J Surg. 2017;43:7-16.

Maheux-Lacroix S, Bergeron C, Moore L, Bergeron MÈ, Lefebvre J, Grenier-Ouellette I, et al. Hysterosalpingosonography Is Not as Effective as Hysterosalpingography to Increase Chances of Pregnancy. J Obstet Gynaecol Can. 2019;41(5):593-598.

Yun AJ, Lee PY. Enhanced fertility after diagnostic hysterosalpingography using oil-based contrast agents may be attributable to immunomodulation. AJR Am J Roentgenol. 2004;183(6):1725-7.

Wang R, van Welie N, van Rijswijk J, Johnson NP, Norman RJ, Dreyer K, Mijatovic V, Mol BW. Effectiveness on fertility outcome of tubal flushing with different contrast media: systematic review and network meta-analysis. Ultrasound Obstet Gynecol. 2019;54(2):172-81.

Roma Dalfó A, Ubeda B, Ubeda A, Monzón M, Rotger R, Ramos R, Palacio A. Diagnostic value of hysterosalpingography in the detection of intrauterine abnormalities: a comparison with hysteroscopy. AJR Am J Roentgenol. 2004;183(5):1405-9.

Downloads

Published

2022-02-25

Issue

Section

Original Research Articles