Comparative evaluation of pattern of abnormalities in hysterosalpingography, diagnostic laparoscopy and hysteroscopy among women with infertility in Zaria, Nigeria

Laparoscopy and hysteroscopy procedures commenced recently in our center and no study has been done on them yet. Also, there is paucity of information in our environment on comparison of laparoscopy/hysteroscopy findings with hysterosalpingography (HSG) amongst infertile women. The purpose of this study was to evaluate pattern of the abnormalities detected on HSG in infertile women and to compare them with laparoscopy and hysteroscopy findings. A prospective study of 220 consecutive patients who had HSG between December, 2011 and May, 2013, at Department of Radiology, Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria was conducted. Clinical notes and radiological findings were analyzed for demographic data, uterine status, tubal and pelvic abnormalities. Findings were correlated with those of laparoscopy and hysteroscopy. Data was analyzed using EPI Info version 3.3.2 for windows. Of the 72 women with tubal occlusion on HSG, 46 (63.89%) women had laparoscopy with dye test. HSG demonstrated unilateral tubal occlusion in 35 (76.09%) women and bilateral tubal occlusion in 11 (23.91%) women. The laparoscopy with dye test also demonstrated unilateral tubal occlusion in 34 (73.91%) women and bilateral tubal occlusion in 10 (21.74) women. The difference in the findings of both tests on tubal patency was not statistically significant (p>0.05). All the 26 women with uterine adhesion on HSG had diagnostic hysteroscopy which confirmed all the cases. There was no difference in the findings of both tests (p>0.05). Both HSG and diagnostic laparoscopy are effective in evaluating tubal patency with no significant difference in accuracy. Also both HSG and hysteroscopy are effective in evaluating intrauterine adhesions with no difference in accuracy.   Key words: Abnormalities, hysterosalpingography, laparoscopy/hysteroscopy, infertility.