Pattern Of Asymptomatic Sexually Transmitted Infections In Women Undergoing Hysterosalpingography For Infertility Evaluation In Ibadan Nigeria

ABSTRACT

The roles of gonorrhea and non-gonococcal urethritis due to Chlamydia trachomatis in the etiology of

infertility due to tubal occlusion have been established by various studies. Hysterosalphingography WSG)

is done to investigate tubal patency. This study was aimed at finding the prevalence of Wptomatic

sexually transmitted infections (STIs) in women being investigated for infertility in a tertiary institution.

Methods: This was a cross-sectional study of asymptomatic infertile women referred for pre-HSG

screening. Detailed medical history, Endocervical and high vaginal swabs were collected to establish

diagnosis of STIs following clinical examination and informed consent. These specimens were evaluated

microscopically for Chlamydia trachomatis and bacterial vaginosis. Endocervical secretions were

Gram-stained for intracellular Gram - Negative diplococci and suspected isolates were confirmed as

Neisseriagonorrhoeae by standard laboratory methods.

Results: There were 250 participants with a mean age of 34.6 years (SD = 5.4, range = 25 -49). The mean

age of sexual debut of participants was 21.5 years (SD = 4.3). Fifty-six (22.5%) of the women engaged in

oral sex while 53 (2 1.2 %) shared their spouses with other sexual partners. 1 7.7% had previous PID, 43.1%

of them has vaginal discharge syndrome. The commonest ST1 was Vulvo- vaginal candidiasis (24.4%) and

others were bacterial vaginosis (18.4%), Chlamydia cervicitis ( 17.6% ), trichomoniasis (11.2% ), and

gonomhea ( 2.4 % ).

Conclusion: The procedure of HSG is invasive and asymptomatic infections in the cervix can be dislodged

and propagated by injectionof contrast to the fallopian tubes thus causing tubal blockage. ~outinPer e-HSG

screening for occult STIs is encouraged to avoid iatrogenic Pelvic Inflammatoty Disease