EVIDENCE BASED INCIDENCE OF TUBAL FACTOR IN SECONDARY INFERTILITY AS DETECTED BY HYSTEROSALPINGOGRAPHY IN WESTERN MAHARASHTRA

Abstract

Anil Joshi1, Rajani Joshi2

BACKGROUND
It is documented that 15% of all women experience primary or secondary infertility at one point in time in their reproductive life. Tubal causes of infertility account for 35 to 40% of causes of infertility. HSG is still a commonly used investigation in the evaluation of the female genital tract and the main indication for the HSG is infertility.
AIMS
? To find out incidence of tubal factor in secondary infertility in Western Maharashtra population.
? To establish reliability of Hysterosalpingography in evaluating tubal status.
MATERIALS AND METHOD
A retrospective study of 464 hysterosalpingographies of women having secondary infertility was done over period of two years. The patients having tubal defects were further studied and statistically analysed. Statistical analysis was performed with the SPSS computer software, version 17.0. Results were presented in tables and graphs.
RESULTS
? Hysterosalpingography has proved to be an ideal (or ‘gold standard’) test to detect tubal abnormalities in infertile women.
? The commonest structural cause of infertility in Western Maharashtra as per this study was bilateral tubal blockage and was commoner in patients with secondary infertility.
CONCLUSIONS
Evaluation of tubal patency and tubal integrity is a key component of the diagnostic work-up in infertile couples.
In conclusion, bilateral tubal occlusion remains the major tubal pathology in female infertility in Western Maharashtra. Tubal blockages with subsequent tubal factor infertility are still common among infertile couples. This may probably be due to chronic pelvic inflammatory disease or pelvic infection following sexually transmitted infections, mismanaged pregnancies and septic abortions, since the majority of the women presented with secondary infertility. Measures to prevent the occurrence of these infections should be paramount.

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