DIAGNOSTIC ROLE OF HYSTEROSALPINGOGRAPHY IN DETECTING TUBAL AND UTERINE CAUSES OF FEMALE INFERTILITY: A CROSS-SECTIONAL STUDY

Abstract

Background: Infertility affects a significant portion of the reproductive-age population globally, with tubal and uterine abnormalities often implicated. Hysterosalpingography (HSG) remains a valuable, minimally invasive diagnostic tool for assessing the patency of fallopian tubes and structural integrity of the uterine cavity. In low-resource settings, it provides an affordable and effective first-line approach to evaluate female infertility, guiding further clinical decision-making and treatment pathways.

Objective: To assess the structural abnormalities of the uterus and fallopian tubes in infertile women using hysterosalpingography.

Methods: This prospective cross-sectional study was conducted over three months at Fatima Memorial Hospital, Lahore, after approval from the Departmental Board of Studies, Department of Radiological Sciences and Imaging, ICBS. A total of 299 women referred for infertility workup underwent HSG using fluoroscopy and iodine-based contrast media. Patients were selected via convenient sampling. Inclusion criteria comprised all women presenting with infertility referred by gynecologists for HSG. Imaging data were evaluated for uterine shape and tubal patency. Statistical analysis was performed using MEDCALC software.

Results: Out of 299 patients, 155 (52%) had secondary infertility and 144 (48%) had primary infertility. Uterine cavities were normal in all participants. Bilateral tubal patency was observed in 213 women (71.2%), while 44 (14.7%) exhibited bilateral tubal obstruction. Unilateral tubal obstruction was detected in 41 patients (13.7%), with 23 cases (7.7%) on the left and 18 cases (6.0%) on the right. A total of 211 patients (70.6%) showed no abnormalities on HSG imaging.

Conclusion: Hysterosalpingography remains a clinically valuable and cost-effective diagnostic tool in evaluating infertile women, particularly for detecting tubal occlusion. The high frequency of tubal pathologies identified reinforces its critical role in early infertility diagnosis and planning of reproductive interventions.