African experience of hysterosalpingography abnormalities tubes management by laparoscopy in infertile women

Mohamed Fanny, Edele Aka, Perel Konan, Luc Olou, Abdoul K. Koffi, Stephane Adjoussou, Konan Seni, Apollinaire Horo, Mamourou Kone


Background: Infertility affects about 80 million people worldwide and one in ten couples. The objective of this study was to report our experience of the contribution of laparoscopy in the diagnostic and prognostic approach of fallopian tubes pathology in infertile women in sub-Saharan Africa.

Methods: We conducted a retrospective study in the Gynecology and Obstetrics unit of Yopougon Teaching Hospital over a 2-year period (January 1, 2017 to December 31, 2018) which included 49 cases of tubo-peritoneal infertility diagnosed by hysterosalpingography (HSG) then laparoscopy procedure.

Results: The average age was 33 years old.  30.6 % were single. 75% had secondary infertility. 59.2% had a medical history of abortion. Pelvic Inflammatory Disease and pelvic surgery accounted 84.2% and 49 respectively. Laparoscopy showed a predominance of distal tubal damage (66.6%) whose 47% hydrosalpinx. Bilateral tubal patency was demonstrated in 77.5% of our patients during laparoscopy procedure. We observed a sensitivity, a specificity, and a concordance laparoscopy / HSG of 63.6%, 80% 63.1% respectively. Laparoscopy also allowed therapeutic procedures such as adhesiolysis or tubal plasty in 22 patients (44.89% of our cases). At the end of laparoscopy procedure, 35 patients (71.42%) were turned towards IVF.

Conclusions: Laparoscopy allows an assessment of tubal abnormalities revealed by hysterosalpingography and the fertility prognostic as well as better therapeutic approach in management of tubal infertility.


Fallopian tubes abnormalities, Hysterosalpingography, Infertility, In-vitro fertilization, Laparoscopy

Full Text:



Brzakowski M, Lourdel E, Cabry R, Oliéric MF, Claeys C, Devaux A. Epidemiology of the infertile couple. J Gynecol Obstet Biol Reprod. 2009;38 Spec No. 1-2:F3-7.

Hamamah S, Anahory T, Ferrière A, Loup V, Reyftmann L, Dechaud H. Therapeutic solutions for male infections. J Gynecol Obstet Biol Reprod. 2009;38 Spec No. 1-2:F58-F64.

Dia JM, Yao I, Guié P, Bohoussou E, Nguessan E, Oyelade M, et al. Epidemiological and etiological aspects of infertile couples in Abidjan. Rev Int Sc Méd. 2016;18(1):22-6.

Belley PE, Tchente NC, Nguemgne C, Nana NT, Taila W, Banag E. Female infertility at Douala General Hospital: epidemiological and radiological aspects (about 658 cases). J Afr Imag Méd. 2015;7(2):16-23.

Rachdi R, Messaoudi F, Ben TY, Basly M, Chlayh M. Contribution of operative laparoscopy in the treatment of female infertility. Tunisie Médicale. 2004;82:837-42.

Mårdh PA. Tubal factor infertility, with special regard to chlamydial salpingitis. Curr Opin Infect Dis. 2004;17(1):49-52.

Mage G, Bruhat MA, Bouquet de la jolinière J, Canis M, Charand S, Dellenbach P, et al. Tubal operability score. Extract from the XXXIIIth French Assize of Gynecological - Poitiers 1987, 93-6 Masson (Paris).

Reyftmann L, Dechaut C, Amar A. What place is left for reproductive surgery? J Gynecol Obstet Biol Reprod. 2009;38 Spec No.1-2:F35-F42.

Kehila M, Ben Hmid R, Khedher BS, Mahjoub S, Bedis MC. Concordance and contributions of hysterosalpingography and laparoscopy in exploration of pelvic and tubal infertility. Pan Afr Med J. 2014;17:126.

Cornier E, Feinsech MJ, Bouccara L. Fibrotuboscopy ampullary. J Gynecol Obstet Biol Reprod. 1984;13(1):49-53.

Brosens I, Boekx W, Delattin P, Puttemans P, Vasquez G. Salpingoscopy: a new pre-operative diagnostic tool in tubal infertility. Br J Obstet Gynaecol. 1987;94:768-73.

Pouly JL. What are the elements of the choice between surgery and IVF in infertility? Contracep Ferttil Stéril. 1992:277-280.