scholarly journals Hysterosalpingography Findings and Jimah Ratio of the Uterine Cavity in Women with Infertility in Central Region, Ghana

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Bashiru Babatunde Jimah ◽  
Philip Gorleku ◽  
Anthony Baffour Appiah
Keyword(s):  
Central Region ◽  
Acute Infection ◽  
Significant Proportion ◽  
Uterine Cavity ◽  
Fallopian Tubes ◽  
Cape Coast ◽  
Secondary Infertility ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
Infertile Women

Background. Infertility affects from 1.3% to 25.7% of couples worldwide and, especially, from 14.5% to 16.4% in Africa. Hysterosalpingography (HSG) is a diagnostic modality that is considered both common and efficient. It is used to investigate abnormalities of the uterine cavity and fallopian tubes. This study assessed the spectrum of findings on HSG among women with infertility in the Central Region (Ghana). Methods. We conducted a prospective cross-sectional study to examine 203 infertile women undergoing HSG work-up at the Cape Coast Teaching Hospital. The exclusion criteria were acute infection of the vagina or cervix and active vaginal bleeding or pregnancy. Data were entered with Microsoft Excel and analyzed using SPSS version 21. Results. A total of 203 women were enrolled, and eighty-five (41.87%) of the women had at least one or more abnormalities. The mean age was 32.9 years with majority of the women within 30–39 years (61.08%). More than half (50.74%) of the women presented with secondary infertility, while age of women ( p = 0.004 ) and duration of infertility (0.034) were found to be in association with the type of infertility. Uterine findings were predominantly capacious uterine cavity (45.1%) and uterine fibroids (33.3%), while fallopian tube findings included bilateral blockage (24.2%), right unilateral proximal blockage (17.7%), loculated spillage (16.1%), and left unilateral proximal blockage (16.1%). The range of normal uterine cavity size, measured as ratio (Jimah ratio) of intercornual diameter to interiliac diameter was 0.2–0.45, with a mean of 0.36. Conclusion. Secondary infertility was the commonest indication for HSG in the study, and a significant proportion of infertile women had abnormalities. Abnormalities were higher in the fallopian tubes than the uterus, while capacious uterine cavity, uterine fibroid, and bilaterally blocked tubes were the top three abnormalities found.

STUDY OF DISTRIBUTION OF REPRODUCTIVE TRACT ANOMALIES IN INFERTILE WOMEN THROUGH HYSTEROSALPINGOGRAPHY IN CENTRAL INDIA

2021 ◽  
pp. 11-12
Author(s):  
Santoshkumar Bhise
Keyword(s):  
Reproductive Tract ◽  
Tertiary Care ◽  
Uterine Cavity ◽  
Central India ◽  
Reproductive Age ◽  
Care Hospital ◽  
Fallopian Tubes ◽  
Observation Study ◽  
Secondary Infertility ◽  
Infertile Women

Context:Infertility has risen to be a public health problem in India, National Family Health Survey (NFHS) – 4 estimates showing 5.2% of the women in reproductive age group to be infertile. Infertility can be due to male factors, female factors and in some cases unexplained; female factors comprising of 40-45% of the total cases. Amongst the female factors anatomical congenital anomalies as well as acquired abnormalities of the reproductive tract may cause primary or secondary infertility. Aims: This study aimed at looking at the distribution of congenital anatomical anomalies of the uterus and fallopian tubes as well as the distribution of anatomical changes in uterus and fallopian tubes due to pathological conditions through Hysterosalpingograhy (HSG) in infertile women. Methods & Materials: 103 women attending Obs. and Gyneac. OPD for diagnosis and treatment of infertility in a tertiary care hospital in Central India were selected in this observation study. Sampling was purposive. HSG was performed and the data was obtained from the department of radiology. Descriptive analysis was done, and where applicable bi-variate analysis was done with chi-square test. Results:There were 63 cases of primary (mean age = 25 years ± 3.2) and 40 cases of secondary infertility (mean age = 30 years ± 2.9). 24% of the total cases had tubal occlusion, 16.5% had hydrosalpinx, 4% had arcuate and bicornuate uterus each and 1 % had unicornuate uterus, lling defects in uterus, deviation of uterine cavity, T-shaped uterus and sub-mucous broid each. 47% of the cases had normal HSG ndings. Conclusions: The results show that acquired causes of tubes were most common ndings in HSG of infertile women, pointing to preventable and easily manageable cases of infections of reproductive tract. Timely management of such cases at primary health care level can help reduction of infertility cases.

scholarly journals Accuracy of saline infusion sonography versus hysteroscopy in the evaluation of uterine cavity abnormalities in infertile women at CHRACERH, Yaounde, Cameroon

2018 ◽  
Vol 7 (11) ◽  
pp. 4355
Author(s):  
Claude C. Noa Ndoua ◽  
Etienne Belinga ◽  
Gaspard G. Ayissi Ngah ◽  
Junie N. Metogo ◽  
Sandrine Mendibi ◽  
...  
Keyword(s):  
Gold Standard ◽  
Uterine Cavity ◽  
Saline Infusion ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
Predictive Values ◽  
Saline Infusion Sonography ◽  
Infertile Women ◽  
Retrospective Data Collection ◽  
Sensitivity Specificity

Background: Uterine cavity abnormalities are seen as a cause of infertility in around 10%-15% and can go up to 50% in women with recurrent implantation failure. Saline infusion sonohysterography (SIS) is a minimally invasive diagnostic modality in the evaluation but hysteroscopy remains the gold standard in the assessment of intra uterine cavity. The aim of this study was to compare the diagnostic accuracy of saline infusion sonography (SIS) considering hysteroscopy (HS) as the gold standard to evaluate uterine cavity pathologies in infertile women at CHRACERH.Methods: Authors carried out a cross-sectional, retrospective study, over 2 years, from the 1st January 2016 to the 31st December 2017, with retrospective data collection in 110 records of infertile patients subjected to an ultrasound assessment of uterine cavity using saline as the contrast medium with a 6.5-MHz transvaginal transducer. When SIS found intra uterine abnormality, HS was done on a later date, using a 5 mm Bettocchi hysteroscope. Sensitivity, specificity, accuracy, positive and negative predictive values of SIS and HS were compared using the SPSS 20 software.Results: The mean age and body mass index were respectively 39.3±7.8 years and 28.7±4.1 kg/m². The main findings both in SIS and Hysteroscopy were respectively polyps (n=61; 55.5% vs 52.7%; n=58), myomas (n=43; 39.1% vs 31.8%; n=35), intrauterine adhesions (n=18; 16.4% vs 21.8%; n=24). The overall sensitivity, specificity and accuracy of SIS were 81.2%, 86.9% and 86.5% respectively.Conclusions: SIS as a diagnostic tool in the evaluation of intrauterine lesions has a good accuracy and can therefore replace HS when this later is not available, especially in our African setting.

scholarly journals Comparison between hysterosalpingography and laparoscopic chromopertubation for the assessment of tubal patency in infertile women

2017 ◽  
Vol 6 (11) ◽  
pp. 4825
Author(s):  
Anjana Choudhary ◽  
Shreya Tiwari
Keyword(s):  
Uterine Cavity ◽  
Moderate Degree ◽  
Age Group ◽  
Secondary Infertility ◽  
Health Care Centre ◽  
Cross Sectional ◽  
Tubal Patency ◽  
Infertile Women ◽  
Number Of Patients ◽  
History Of

Background: Infertility is a critical component of reproductive health, and has often been neglected in these efforts. The inability to have children affects men and women across the globe. Infertility can lead to distress and depression, as well as discrimination and ostracism. Hysterosalpingography (HSG) of infertile women is useful for the assessment of structure of uterine cavity, tubes and their patency. However, although a more invasive procedure such as laparoscopy (L/S) which is regarded as the most reliable method in detection of tubal pathologies in infertility.Methods: This was a Prospective cross sectional study of 50 patients with history of primary or secondary infertility selected from IPD of Jawaharlal Nehru medical College and Acharya Vinobha Bhave Rural Hospital, Tertiary Health Care Centre Located in Sawangi, Wardha, Maharashtra (India).  The age group of the patients was between 18 yrs. - 45 yrs. The study population was selected depending upon the total number of patients (fitting the criteria) visiting the IPD of AVBRH Department of Obstetrics and gynecology for a period of 1 years (September 2015 to September 2016). The collected data was compiled and proper statistical formulas were applied to analyze the data collected.Results: The present study include 50 cases of both primary and secondary infertility of which 29 cases (58%) were primary infertility and 21 cases (42%) were secondary  infertility. In this study the 3(6%) cases were found in the age group of <20 years followed by 16 (32%) cases in the age group of 21-25 years, 19(38%) cases were in the age group of 26-30 years while 7(14%) cases were in the age group of 31-35years the age group of 36-40 years 2(14%) and in age group > 40 years is 3(6%). In the present study, based on Kuppuswamy index most (30%) of the women had class IV socio economic status in both primary and secondary infertility. In the present study, there were 6 (28.57%) cases with History of LSCS, 7 cases (33.33%) had FTND, 6(28.57%) cases had history of abortion, and 2(9.52%) had previous ectopic pregnancy. Moderate degree of agreement was found between findings of both tests.Conclusions: The results suggest that hysterosalpingography is useful as a primary screening procedure, but laparoscopy provides a more accurate assessment of tubal patency in the investigation of infertility.

scholarly journals Hysterosalpingographic Evaluation of Uterus and Fallopian Tubes of Infertile Women

2017 ◽  
Vol 6 (1) ◽  
pp. 63-71 ◽  
Author(s):  
Manoj Bhattarai ◽  
Sita Pokhrel Ghimire
Keyword(s):  
Fallopian Tube ◽  
Uterine Cavity ◽  
Categorical Variables ◽  
P Value ◽  
Fallopian Tubes ◽  
Secondary Infertility ◽  
Radiological Investigation ◽  
Infertile Women ◽  
Primary Infertility ◽  
Significant Difference

Background: Hysterosalpingography (HSG) is a routinely performed radiological investigation for evaluation of uterine cavity morphology and fallopian tube patency in infertile women. This study was undertaken to describe patterns of HSG findings and to assess any significant difference in uterine and fallopian tube findings in women with primary and secondary infertility in eastern part of Nepal.Material and Methods: Hospital based cross sectional descriptive study was conducted by retrospectively analyzing HSG records of 216 infertile women (both primary and secondary infertility) done from April 2014 to August 2016. Radiological findings in uterus and fallopian tubes were recorded and analyzed. Association between two categorical variables was examined by Chi-square test.Results: Majority of infertile women (53.2%) had primary infertility. Abnormal HSG was seen in 44.9% infertile women and higher in secondary infertility (57.4%) than with primary infertility (33.9%) (OR = 2.63, 95% CI = 1.51 – 4.57, P value = 0.001). Tubal abnormality was common than uterine abnormality (36.1% versus 8.8%, P value= 0.001). Tubal abnormalities were higher in women with secondary infertility than with primary infertility (52.5% versus 21.7%), whereas uterine abnormalities were common with primary infertility compared to secondary infertility (12.2% versus 5.0%) (P value= 0.001).Conclusion: Abnormal HSG was more associated with secondary infertility. Infertility was significantly associated with tubal abnormality than with uterine abnormality. Tubal abnormalities are common in women with secondary infertility whereas uterine abnormalities are common in women with primary infertility and are statistically significant.Journal of Nobel Medical CollegeVolume 6, Number 1, Issue 10 (January-June, 2017), Page: 63-71

Prevalence and distribution of causes of infertility according to women’s age – a cross-sectional study in a tertiary healthcare hospital setup

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Keerthana Dhandapani ◽  
Bhagyalakshmi Kodavanji ◽  
Vinodini Nithyananda Madom Anantharaya ◽  
Nayanatara Arun Kumar
Keyword(s):  
Tertiary Care ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Female Infertility ◽  
Secondary Infertility ◽  
Cross Sectional ◽  
Female Population ◽  
Infertile Women ◽  
Tertiary Healthcare ◽  
The Individual

Abstract Objectives Infertility has disastrous consequences, particularly for women. Causes of infertility in developed countries have been investigated but there is a significant lack of data among Indian female population. The aim of the present study was to analyze the causes and the proportion of the individual factors contributing to infertility, considering the age factor. Methods The data of 204 infertile women (18–45 years) were collected from the files in tertiary care hospitals. Causes and age of infertile women were grouped. The prevalence of each cause was evaluated. Data analysis was done using SPSS (Statistical Package for Social Sciences) version 17.0. Results Polycystic ovarian syndrome (PCOS) was the most common (14.71%) cause of female infertility. Ovulatory dysfunctions (25.55%) were the foremost cause in primary infertility, whereas in secondary infertility, uterine factors (26.86%) were most common. The incidence of primary and secondary infertility was more evident in patients who were more than 30 years of age. Conclusions Causes of infertility vary according to the age. The causes of female infertility were unexplained infertility, ovulatory disorders and uterine factors most commonly affecting women at ≤30 years.

scholarly journals Comparison of Hysterosalpingography and Combined Laparohysteroscopy for the Evaluation of Primary Infertility

2017 ◽  
Vol 13 (4) ◽  
pp. 281-285 ◽  
Author(s):  
A. Nigam ◽  
P. Saxena ◽  
A. Mishra
Keyword(s):  
Detection Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Uterine Cavity ◽  
Cervical Canal ◽  
Diagnostic Modality ◽  
Infertile Patient ◽  
Infertile Women ◽  
Intrauterine Abnormalities

Background Hysterosalpingography (HSG) is a useful screening test for the evaluation of female infertility. Laparoscopy has proven role in routine infertility work up but role of hysteroscopy in an infertile patient with normal HSG for additional information is a subject of debate. Hysteroscopy permits direct visualization of the cervical canal and the uterine cavity and thereby helping in the evaluation of shape, and cavitary lesion.Objective To detect uterine abnormalities in infertile women by various approaches i.e. HSG and hysteroscopy and evaluating the role of combining hysteroscopy with laparoscopy for the evaluation of tubo-uterine factor for primary infertility.Method One twenty eight infertile women were evaluated and HSG was performed as a basic test for evaluation of tubes and uterine cavity. Women were subjected to combined laparoscopic and hysteroscopic examination on evidence of HSG abnormalities. In absence of any HSG abnormality, women were subjected to ovulation induction for three to six months and if they did not conceive during this period they were undertaken for combined laparo-hysteroscopic evaluation.Result The positive predictive value of HSG for detecting the intrauterine abnormalities was 70% among 126 patients where the hysteroscopy could be performed successfully. The diagnostic accuracy of HSG for intrauterine abnormalities revealed false negative rate of 12.96%. The most frequent pathologies encountered by laparoscopy were tubal and/or peritoneal and were found in 68% (87/128) of women. Total 64.06% infertile women had some abnormality on laparoscopy. This detection rate has been increased from 64.06% to 71.86% on including the concomitant hysteroscopy.Conclusion HSG is a good diagnostic modality to detect uterine as well as tubal abnormalities in infertile patient. HSG and hysteroscopy are complementary to each other and whenever the patient is undertaken for diagnostic laparoscopy for the infertility, hysteroscopy should be combined to improve the detection rate of abnormalities especially in communities where there is enormous risk of pelvic infection.

scholarly journals VAGINAL SONOGRAPHY a HYSTEROSCOPY

2009 ◽  
Vol 16 (03) ◽  
pp. 432-437
Author(s):  
MASOMEH ASGHARNIA ◽  
Zahra Mohammad Tabar ◽  
MARZIEH MEHRAFZA ◽  
Mary am Shakiba ◽  
MONA OUDI ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Uterine Cavity ◽  
Cross Sectional Study ◽  
Therapeutic Modality ◽  
Histological Evaluation ◽  
Complete Evaluation ◽  
Cross Sectional ◽  
Predictive Values ◽  
Infertile Women ◽  
Sensitivity Specificity

B a c k g r o u n d : Hysteroscopy is a valuable diagnostic and therapeutic modality in the management of infertility. A i m : To evaluatethe consistency of hysteroscopy based on a histopathological report from endometrial specimens for intrauterine disorders. Materials andMethods: This is a cross-sectional study. The study included 115 infertile patients. All were admitted for investigation of infertile women beforeassisted reproduction in Mehr infertility institute between 2006 and 2007 hysteroscopy, and histological evaluation of endometrial biopsyperformed.We compared the efficacy of hysteroscopy in the diagnosis of benign intrauterine pathology in infertile women in whom the diagnosiswas confirmed by histologic studies. The women had a complete evaluation with preoperative hysteroscopy, and histological analysis of uterinecavity specimens. Sensitivity, specificity, predictive and negative predictive values were calculated for hysteroscopy considering the histologicalstudy as 100%. Results: Sensitivity and specificity of sonography in diagnosing the polyp were stated 81 % and 64% respectively. Sensitivityand specificity of hysteroscopy showed of polyps revealed 85% and 84% respectively. The results indicated that Sensitivity and specificity ofsonography in diagnosing the myoma were 25% and 98% respectively. Sensitivity and specificity of hysteroscopy in diagnosing the myomawere expressed 50% and 93% respectively. C o n c l u s i o n : Hysteroscopy is a safe and rapid direct visualisation of the uterine cavity. We believeit should be replaced by the diagnostic hysteroscopy as a first line infertility investigation.

scholarly journals Investigating Hysteroscopy Implementation in Infertile Women Candidate With a Normal Uterine Cavity for Laparoscopy in Hysterosalpingography

2018 ◽  
Vol 7 (1) ◽  
pp. 79-84
Author(s):  
Maliheh Amirian ◽  
Anis Darvish Mohammadabad ◽  
Negar Morovatdar ◽  
Leili Hafizi
Keyword(s):  
Diagnostic Laparoscopy ◽  
False Negative ◽  
Uterine Cavity ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Endometrial Polyps ◽  
Infertile Women ◽  
Submucous Myoma ◽  
Age Range

Objectives: Endometrial pathologies inside the cavity can occur simultaneously with gestational unpleasant consequences but are not always capable of being diagnosed by the hysterosalpingography (HSG). This study aimed to examine the value of performing diagnostic hysteroscopy beside diagnostic laparoscopy among infertile women with normal uterine cavities in HSG. Materials and Methods: A total of 103 infertile women with normal uterine cavities in the HSG and within the age range of 18-40 who referred to Imam Reza hospital for laparoscopy during 2016-2017 were included in this cross-sectional study. Hysteroscopy was performed simultaneously with diagnostic laparoscopy. Then, the existence of uterine pathologies like endometrial polyps, submucous myoma, and uterine endometrial adhesions and their relationship with the patient’s age, infertility type and duration, and cycle time were evaluated. A P value less than 0.05 was considered statistically significant. Results: Overall, 64 patients (63.1 %) had a normal uterine cavity in the hysteroscopy while 39 of them had an abnormal uterine cavity, the HSG false negative cases of whom were reported 37.9%. The pathologies found in the hysteroscopy were endometrial polyp (16 cases), submucous myoma (1 case), uterine septum (6 cases), asherman syndrome (7 cases), bicornuate uterus (4 cases), polyp + asherman (3 cases), polyp + submucous myoma (1 case), and septum + submucous myoma (1 case). Patients’ age, type of infertility, and menstruation time during performing hysteroscopy made no particular difference in diagnosing pathologies of the uterine cavity in the hysteroscopy. Conclusions: Based on the findings, conducting hysteroscopy in infertile women who are candidates of laparoscopy and have normal uterine cavities in HSG can result in recognizing some cases of uterine pathologies which influence the outcomes of future pregnancies is not dependent upon the patient’s age, menstruation time, type and duration of infertility, and result of laparoscopy.

Hysteroscopic Management of Intrauterine Pathologies: A Case Series of 296 Patients

2017 ◽  
Vol 5 (1) ◽  
pp. 35-40
Author(s):  
Rahul Manchanda ◽  
Charu Pathak ◽  
Garima Yadav
Keyword(s):  
Case Series ◽  
Uterine Cavity ◽  
Postmenopausal Bleeding ◽  
Secondary Infertility ◽  
Diagnostic Modality ◽  
Endometrial Polyps ◽  
Detection Rates ◽  
Primary Infertility ◽  
Endocervical Canal ◽  
Infertility Patients

ABSTRACT Aims To discuss the incidence of various hysteroscopic findings in patients of infertility, abnormal uterine bleeding (AUB), and postmenopausal bleeding and to compare the prevalence of various uterine pathologies in patients of primary and secondary infertility. Materials and methods This is a retrospective observational study, which evaluated 296 patients who underwent diagnostic hysteroscopy for evaluation of primary or secondary infertility, AUB, and postmenopausal bleeding over a period of 18 months in a Gynae-endoscopy Unit. Detailed hysteroscopic evaluation of the endocervical canal and uterine cavity in all recruited cases was done by the same surgeon and the data were collected by reviewing the case records. Results Among the 296 cases analyzed, 157 cases were of primary infertility, 81 cases were of secondary infertility, 45 cases were of AUB, and 13 cases presented with postmenopausal bleeding. Among the primary infertility patients, 58.6% had abnormal findings on hysteroscopy, while among the secondary infertility patients, hysteroscopy revealed abnormalities in as high as 72.5% cases. In the present study, uterine synechiae was the most common abnormality detected among the infertile patients. Endometrial polyps were the most common pathology detected among patients with AUB and postmenopausal bleeding. Conclusion Hysteroscopy is a minimally invasive and highly safe technique to directly visualize the endocervical canal, uterine cavity, and tubal ostia. It has an added advantage of treating the pathology in the same sitting, thus improving the clinical outcomes. Based on our findings, we conclude that uterine pathologies are a major contributor in causing infertility and menstrual irregularities, which are missed on blind modalities like hysterosalpingography and dilatation and curettage. Clinical significance This article stresses on the use of hysteroscopy as a primary diagnostic modality in evaluating patients of infertility, AUB, and postmenopausal bleeding in order to increase the detection rates of uterine pathologies. How to cite this article Yadav G, Manchanda R, Pathak C. Hysteroscopic Management of Intrauterine Pathologies: A Case Series of 296 Patients. J South Asian Feder Menopause Soc 2017;5(1):35-40.

scholarly journals Role of Radiographic Hysterosalpingography in Infertility in Eastern Nepal

2013 ◽  
Vol 3 (1) ◽  
pp. 59-66
Author(s):  
Pranav Kumar Santhalia ◽  
MK Gupta ◽  
D Uprety ◽  
K Ahmad ◽  
S Ansari ◽  
...  
Keyword(s):  
Uterine Cavity ◽  
Image Intensifier ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Vital Role ◽  
Female Infertility ◽  
Imaging Features ◽  
Fallopian Tubes ◽  
Cross Sectional ◽  
Ionic Contrast

Background: Hysterosalpingography (HSG) is the radiographic technique for evaluation of uterine cavity and fallopian tubes. It still remains the best imaging procedure for fallopian tubes despite the advent of newer modalities and is used primarily for the evaluation of female infertility.1,2 The purpose of the study was to assess the uterine and tubal abnormalities detected on radiographic HSG as causative factors of infertility and to describe their imaging features. Methods: This prospective cross sectional study was conducted at the Department of Radiodiagnosis and Imaging, BPKIHS, Dharan. Forty-four patients with infertility (both primary and secondary) referred for HSG were included. HSG was performed using non-ionic contrast medium under image intensifier fluoroscopic control during the follicular phase of menstrual cycle. Radiographic films were obtained and analyzed. Results: Out of the total 44 patient, 26 (59.0%) had primary infertility while 18 (41.0%) had secondary infertility. Tubal abnormalities were seen in 28 (63.6%) and uterine abnormalities in 2 (4.6%) patients. The most common tubal abnormality detected on HSG was tubal block (50.0%). Unilateral and bilateral tubal blocks were equally distributed (50.0% each). Proximal tubal block was observed in 8 (36.4%) and distal in 13 (59.1%) patients. Fifteen (34.1%) patients had hydrosalpinx. Conclusion: HSG is easy, safe, and cost-effective and plays vital role in the evaluation of female with infertility. The most common structural cause of female infertility found as per this study was tubal block. Nepalese Journal of Radiology / Vol.3 / No.1 / Issue 4 / Jan-June, 2013 / 59-66 DOI: http://dx.doi.org/10.3126/njr.v3i1.8810

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