ABSTRACT
HSG is a commonly performed examination due to increasing popularity of reproductive medicine and infertility. It plays an important role in evaluation of abnormities related to uterus and fallopian tubes. This research work is a retrospective research study aimed at determining the common findings in hysterosalpingography at Federal Medical Centre Asaba, from May 2011 to April 2013. The patients that met the inclusive criteria were those that were diagnosed to be infertile.
The results show that the commonest finding is uterine fibroid 83(33.20%) and the type of findings occurring list is salpingitis isthmica nodosa 1(0.40%). The predominant ages were found to be between 30 – 34 years 101(40.40%). The earliest onset of these findings on HSG is 20 years and 30 – 34 years of group has the highest occurrence. There was also a strong negative correlation between the age of the patient and the findings on HSG.
This led to the conclusion that uterine fibroid is the major cause of infertility in women in this locality and is commonly seen among the mid-years. This if discovered on time and managed well will increase the chances of infertile women becoming fertile.
LIST OF TABLES
Table 1: Cross tabulation on findings on HSG
Table 2: Age and Findings Correlations
LIST OF FIGURES
Figure 1: Diagram of the female reproductive system
TABLE OF CONTENTS
Title page……………………………………………………..…….………. I
Approval Page…………………………………………………..…..........… II
Certification……………………………………………………..………….III
Dedication………………………………………………………...…….….. IV
Acknowledgement…………………………………………………..…....… V
List of tables …………………………………………………………...….. VI
List of figures…………………………………………………..………….. VII
Abstract ……………………………………………………..…………….. VIII
Table of Contents…………………………………………………….......….I
CHAPTER ONE: INTRODUCTION
1.1 Background of study ......................................................................….... 1
1.2 Statement of problem………………………………………........…..... 2
1.3 Purpose of study………………………………….................………….3
1.4 Significance of study …………………………………….....………… 3
1.5 Scope of study…………………………………………….……….. … 3
1.6 Literature review…………………………………………....………… 4
CHAPTER TWO: THEORETICAL BACKGROUND
2.1 The female reproductive system …………….……………...……….10
2.2 Infertility…………………………………………………………… 19
2.2.1 Causes of Infertility………………………………………… 20
2.3 Hysterosalpingography………………………………………….….. 23
CHAPTER THREE: RESEARCH METHODOLOGY
3.1 Research Design………………………..………..………………… 25
3.2 Area of study……………………………………..…….…………... 25
3.3 Target Population…………….…………………..………………… 25
3.4 Inclusion Criteria…………………………………..………………. 25
3.5 Exclusion Criteria…………………………………..……………… 25
3.6 Procedure of Data Collection…………………………...………….. 26
3.7 Method of Data Analysis……………………………..……………. 26
CHAPTER FOUR: PRESENTATION AND DATA ANALYSIS
4.1 Data Analysis…………………………………….………………… 28
CHAPTER FIVE: DISSCUSION, SUMMARY OF FINDINGS, CONCLUSION, RECOMMENDATION, AREA OF FURTHER RESEARCH AND LIMITATION.
5.1 Discussion…………………………………….…..…..……………. 30
5.2 Summary of Findings……………………………….………………. 31
5.3 Conclusion …………………………………………………….…... 32
5.4 Recommendation ………………………………………………….. 32
5.5 Area of Further Research …………………………………….……. 32
5.6 Limitations…………………………………………………………. 33
References……………………………………………………......……. 34
Appendix……………………………………………………………….. 37
INTRODUCTION
Hysterosalpingography (HSG) is the radiographic evaluation of the uterus and fallopian tubes 1. It can also be defined as the radiographic examination of endocervical canals, uterine cavity and fallopian tube with the use of a radiographic contrast medium 2. It is used predominantly in the evaluation of infertility. Other indications for HSG include the evaluation of women with a history of recurrent spontaneous abortions, the postoperative evaluation of women who have undergone tubal ligation or reversal of tubal ligation, and the assessment of patients prior to myomectomy . Hysterosalpingography (HSG) is the most commonly used technique in the evaluation of infertility. It has traditionally been considered the gold standard for assessment of the fallopian tubes, giving reliable information about their patency and morphology. It is also recommended for the study of the uterine cavity in the diagnosis of and treatment planning for other gynecologic problems such as intrauterine adhesions and congenital anomalies. HSG is an indirect means of showing the interior of the uterus and fallopian tubes. Endometrial lesions are shown as filling defects or uterine wall irregularities. HSG also enables visualization of the general configuration of the cavity.
Hysterosalpingography may show normal findings, which will show a healthy, normal shaped uterus and unblocked fallopian tubes. Intra uterine filling defects caused by intra-uterine adhesion, sub mucous fibroids, endometrial polyps. There may be a reduction in the size of the uterine cavity depending on the severity of the intra-uterine adhesion. Fibroids and endometrial polyps in addition to causing luminal filling defects, will also cause uterine cavity enlargement and sometimes deformities.
Infertility is defined as the inability of a couple to achieve conception after 12 months of unprotected coitus of average frequency 3. The major causes of infertility are Failure to Ovulate, Poorly Functioning Fallopian Tubes disorders, endometriosis and other factors such as fibroid, polyps and adenomyosis which may lead to obstruction of the uterus and Fallopian tubes, behavioral factors, environmental and occupational factors. Tubal disease is among the most common cause of infertility cases from other studies. The major causes of infertility has not yet been documented in Asaba. This study was conducted in Federal M edical Center Asaba,Delta state.