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. 2024 Mar 31;39(2):e609.
doi: 10.5001/omj.2024.57. eCollection 2024 Mar.

Hysterosalpingographic Findings Among Ghanaian Women with Infertility: A Five-year Trend Analysis

Emmanuel Kobina Mesi Edzie  1   2 , Klenam Dzefi-Tettey  3 , Philip Narteh Gorleku  1 , Edmund Kwadwo Kwakye Brakohiapa  4 , Michael Kofi Amedi  5 , Frank Quarshie  6 , Abdul Raman Asemah  1 , Obed Nimo  7 , Abubakari Bawah Abdulai  8 , Emmanuel Akorli  8 , Richard Ato Edzie  1 , Richard Anthony  9 , Evans Boadi  2 , Joshua Mensah Kpobi  2 , Nana Ama Amankwa  10 , Aaron Amartey  11 , Veronica Turkson  1 , Stella Mensah  12 , Prosper Dziwornu  1 , Alfred Edzie  1 , Roger Afful  12 , Bright Appiah Coffie  12 , Henry Kusodzi  1
Affiliations

Hysterosalpingographic Findings Among Ghanaian Women with Infertility: A Five-year Trend Analysis

Emmanuel Kobina Mesi Edzie et al. Oman Med J. .

Abstract

Objectives: To understand the pattern of hysterosalpingographic (HSG) findings and annual trends among Ghanaian women with infertility over a five-year period.

Methods: We retrospectively evaluated the hospital medical records of women with infertility who underwent HSG at a major tertiary center in Ghana between January 2018 and December 2022. The data was statistically analyzed.

Results: The subjects comprised of 2324 Ghanaian women diagnosed with clinical infertility. HSG identified 1685 (72.5%) with primary infertility and they were also younger women with a mean age of 32.2±4.5 years. The remaining 639 (27.5%) women had secondary infertility and were older (34.2±5.3 years; p < 0.001). Primary infertility rate decreased with increasing age (p < 0.001). Bilateral tubal blockage was seen in 701 (41.6%) women with primary infertility and 365 (57.1%) women with secondary infertility. Hydrosalpinx was present in 236 (10.2%) women, fimbrial adhesions in 444 (19.1%), Asherman's syndrome in four (0.2%), and bilateral beaded tubes/tubercular salpingitis in five (0.2%). HSG was unable to detect infertility-related abnormalities in 513 (22.1%) women despite their clinical infertility. The majority of patients (1502; 64.6%) had tubal blockage: bilateral in 1066 (45.9%) and unilateral in 436 (18.8%).

Conclusions: Infertility rates among Ghanaian women increased at an accelerating rate over the years. Primary infertility was significantly more prevalent among younger women. Tubal and cervical abnormalities were the most prevalent HSG findings.

Keywords: Female Infertility; Ghana; Hysterosalpingography; Prevalence.

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Figures

Figure 1
Figure 1
Prevalence of primary and secondary infertility in Ghanaian women stratified by age group.
Figure 2
Figure 2
A frontal hysterosalpingography image showing pooling of contrast medium around the cervical cannula suggestive of a patulous cervix as indicated by the red arrow, backflow of contrast (yellow arrow), right tubal blockage (green arrow), and left tubal blockage (white arrow).
Figure 3
Figure 3
A hysterosalpingography image showing bilateral tubal dilatation with no spillage of contrast medium bilaterally into the peritoneal cavity as depicted by the left and right arrows suggestive of bilateral hydrosalpinxes.
Figure 4
Figure 4
Yearly trend of infertility from 2018–2022 among Ghanaian women.
Figure 5
Figure 5
A frontal hysterosalpingography radiograph showing free intraperitoneal bilateral spillage (right spillage: red arrow and left spillage: yellow arrow) suggestive of bilateral tubal patency.
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