Hysterosalpingographic evaluation of primary and secondary infertility

OBJECTIVE To determine the pathological patterns of fallopian tubes and uterus on hysterosalpingogrphy (HSG) examination in cases of infertility. METHODS Two years retrospective charts review of patients referred to our centre for HSG evaluation of infertility, from July 2008 to July 2010. RESULTS Four thousand one hundred eight hysterosalpingograms were carried out at our centre during the study period. Out of these, 1999 (48.6%) were primary infertility cases while the 2109 (51.3%) were of secondary infertility. Mean age of presentation for primary infertility was 30 years and 35 years for secondary infertility. Bilateral free peritoneal spill was noted in 60% of cases. Unilateral tubal blockage was present in 15% and bilateral tubal blockage in 10% of patients. Bilateral hydrosalpinx was present in 10% of patients and unilateral loculated spill was found in 5% of patients with primary infertility. Patients with uterine congenital anomalies were also evaluated and the frequency of bicornuate uterus was 4%, unicornuate uterus was 2% and uterine didelphys was 0.2%. CONCLUSIONS Infertile patients who underwent HSG were mostly in older age group with secondary infertility being slightly more common emphasizing early work up and care. Most of the patients with primary infertility had normal HSG examination. To our knowledge this is the largest data for HSG to be presented from Pakistan.