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Hysterosalpingogram, laparoscopy and hysteroscopy in the assessment of the infertile Nigerian female.

Sixty-nine infertile Nigerian females were evaluated with hysterosalpingogram (HSG), laparoscopy and hysteroscopy as part of infertility workup at the endocrine-infertility clinic of the Jos University Teaching Hospital. HSG showed evidence of tubo-peritoneal disease in 45 (65%) women. This was confirmed by laparoscopy in 41 women giving an accuracy of 91% and a false positive rate of 9%. Intrauterine abnormalities were shown on HSG in 4 women and confirmed in 3 women at hysteroscopy giving an accuracy rate of 75% or a false positive rate of 25%. Intrauterine abnormalities were detected in 21 women in whom HSG was normal, giving a false negative rate of 30.4% for HSG. Tuboperitoneal disease was found at laparoscopy in 6 women in whom HSG was normal, giving a false negative rate for HSG of 8%. Our data confirm that laparoscopy and hysteroscopy are superior to HSG in detecting tubo-peritoneal and uterine abnormalities. Despite these findings, we believe that the three procedures are complementary in the evaluation of infertile couples in this country.