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Role of HSG in diagnosing uterine and tubal factors of sub-fertility

Background: Infertility is a common gynaecological condition affecting couples all over the world. Hysterosalpingography (HSG) is a basic, minimally invasive first line investigation in the evaluation of the female. It helps in identifying anatomical defects in the uterine cavity and cervical canal, patency of the fallopian tubes and peritoneal spill. Aim: The aim of the study was to determine the spectrum of abnormalities of uterus and tubes detected by HSG in women attending fertility clinic in Saveetha medical college and hospital. Study design: It is a retrospective observational study conducted at the fertility clinic, Saveetha Medical College. Materials and Methods: The demographic details and x-ray images of HSG of women who have attended fertility clinic between April 2018 and December 2018 and were collected from the medical records department. 102 HSG images were retrieved, studied and analysed. Results: The mean age of the women evaluated was 29.3yrs+SD. The duration of infertility ranged between 1.5 years and 19 years. Of the 100 HSG images 35 were normal, 65 had at least one abnormality, out of which 36 had uterine abnormalities and 60 had abnormal tubes. The uterine abnormalities identified were filling defects (7), endometrial outline abnormalities (22). Among these, the Mullarian abnormalities detected were arcuate (2), septate / bicornuate uterus (5). The tubal pathology seen were tubal block (37), hydrosalphinx (19) and salphingitisisthmica nodosa (3), beaded appearance (1), lead pipe tubes (1), cobble stone (1) and cotton wool appearance (3). Conclusion: Primary infertility was the commonest indication for HSG. Abnormal tubes were the commonest abnormality detected in HSG followed by uterine abnormality indicating tubal factor as a major factor in female infertility.