Hysterosalpingographic Indications and Findings among Women Presenting to Radiology Department of Rivers State University Teaching Hospital

Vivian Ndidi Akagbue *

Department of Radiology, Rivers State University Teaching Hospital, Nigeria.

Esther I. Nonye-Enyidah

Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Nigeria.

Gbenga Jacob Aderibigbe

Department of Radiology, University of Port Harcourt Teaching Hospital, Nigeria.

*Author to whom correspondence should be addressed.


Background: Hysterosalpingography (HSG) is one of the imaging modality used in evaluating females presenting with complaints of infertility. Infertility is not just the issue of the couples alone both the extended family is involved in the typical African environment, therefore it is essential to identify possible causes and proffer solutions where possible.

Aim: This study is aimed at documenting the indications and findings among women presenting for hysterosalpingographic studies in the Radiology Department of Rivers State University teaching Hospital (RSUTH).

Setting and Design: A retrospective study, was conducted at the Radiology and the Obstetrics and Gynaecology Departments of a tertiary hospital.

Materials and Methods: Assessment of patients who had Hysterosalpingography (HSG) done from 1st January, 2020 to 31st May, 2022 in the Radiology Department of RSUTH. Biodata and indications for the study were obtained from the request forms and the HSG findings were also obtained from results pool.

Statistical Analysis: Data were analyzed using SPSS 21.0 version. The level of statistical significance was set at p<0.05.

Results: A total of 305 women data were analyzed. The age of the study group was between 21 to 48years with a mean age of 35.21±5.48years. Majority of the age group was 31-35years (n=96, 31.5%). Secondary infertility (n=216, 70.8%) was the most common indication for HSG. Normal HSG was seen in 84(27.5%) of the patients and others had one pathology or the other. Commonest uterine pathology is uterine fibroids (n=100, 32.8%) and bilateral tubal occlusion (n=47, 20.8%) is the most frequent tubal pathology. There was a significant association between age and tubal occlusion (P=0.007).

Conclusion: HSG is still a valuable tool for investigating women in gynaecological clinics. Tubal occlusion is the prevailing pathology from this study and secondary infertility is the most common indication for HSG.

Keywords: Indications, women, hysterosalpingography, fallopian tubes, uterus, contrast material

How to Cite

Akagbue, V. N., Nonye-Enyidah, E. I., & Aderibigbe, G. J. (2022). Hysterosalpingographic Indications and Findings among Women Presenting to Radiology Department of Rivers State University Teaching Hospital. Journal of Advances in Medical and Pharmaceutical Sciences, 24(9), 14–24. https://doi.org/10.9734/jamps/2022/v24i9576


Theordore A, Baramki MD. Modern trends in hystersalpingography. Fertil Steril. 2005;83(6):1595-606.

Bacevac J, Ganovic R. Diagnostic value of hysterosalpingography in examination of fallopian tubes in infertile women. Srpski arhiv za celokupno lekarstvo. 2001;129(9-10):243-6.

Kdous M. Hysterosaipingography in the assessment of tubal patency. La Tunisie Medicale 2006;84(8):520-5.

Siegler A. Hysterosalpingography. In Wallach E and Zacur H (eds). Reproductive medicine and surgery, Mosby Baltimore; 1986.

Schwabe MG, Shapiro SS, Haning Jr RV. Hysterosalpingography with oil contrast medium enhances fertility in patients with infertility of unknown etiology; Fertil Steril. 1983;40(5):604-6.

Sala E, Allison S, Ascher SM, Hricak H. Imaging in Gynecology. In: Adams A and Dixon A.K(eds). Grainger and Allison`s Diagnostic Radiology. A textbook of Medical Imaging Volume 2. 5th Edition. Churchill Livingston, Elsevier London, UK. 2008;1217-1241.

Evers JL, Collins JA. Assessment of efficacy of varicocele repair for male subfertility: a systemic review Lancet 2003;361: 1849-52. Evers JL, Collins JA. Assessment of efficacy of varicocele repair for male subfertility: a systemic review Lancet. 2003;361(9372):1849-52.

Okonofua FE. Infertility in the Sub-Saharan Africa. Okonofua F, Odunsi K (eds). Contemporary Obstetrics and Gynaecology for developing countries. WHARC Benin city, Nigeria. 2003;128- 156.

Ogunniyi SO, Makinde OO, Dare FO. Abortion-related deaths in Ile-Ife, Nigeria: a 12- year review. Afr J Med Med Sci 1990;19(4):271-4.

Idrisa A Infertility. In Kwawukume EY, Emuveyan EE (eds). Comprehensive Gynaecology in the Tropics. Accra Graphics packaging. 2005;333-43.

Adetoro OO, Ebomoyi EW. The prevalence of infertility in a rural Nigerian community. Afr J Med Sci. 1991;20(1):23-7.

Reis MM, Soares SR, Cancado ML, Camargos AF. Hysterosalpingo-contrast Sonography(HyCoSy) with SH U 454 (Echovist) for assessment of tubal patency. Hum Reprod (Oxf, Engl). 1998;13(11): 3049-52.

Kirkwood BR, Sterne JAC. Calculation of required sample size. Essential Medical Statistics. 2nd Ed. United Kingdom: Blackwells Science. 2003;420-1.

Kiridi EK, Oriji PC, Ugwoegbu JU, Abasi IJ. Hysterosalpingography Findings among Women Presenting for Infertility Evaluation in Bayelsa State, South-South Nigeria. J Adv Med Res. 2022;34(5):7-17.

DOI: 10.9734/JAMMR/2022/v341531292

Balen VF. Interpreting infertility; social science research on childlessness in a global perspective . Amsterdam. Afr J Reprod Health. 2000;4:120-2.

Danfulani M, Ahmed S, Haruna Y. Hysterosalpingographic findings in women with infertility in Sokoto North-Western Nigeria. Afr J Med Health Sci. 2014;13(1):19-23.

DOI: 10.4103/2384-5589.139438

Okafor CO, Okafor CI, Okpala OC, Umeh E. The pattern of hysterosalpingographic findings in women being investigated for infertility in Nnewi, Nigeria. Niger J Clin Pract. 2010;13(3):264-7.

Onwuchekwa CR, Oriji VK. Hysterosalpingographic (HSG) pattern of infertility in women of reproductive age. J Hum Reprod Sci. 2017;10(3):178-84.


Aduayi OS, Akanbi GO, Akintayo AA, Aduayi VA. Hysterosalpingography findings among women presenting for gynaecological imaging in Ado-Ekiti, S outh Western Nigeria. Int J Rreprod Contracept Obstet Gynecol. 2016;5(6):1906-12.

DOI: 10.18203/2320-1770ijrcog20161688.

Imo AO, Sunday-Adeoye I. Radiological assessment of the uterus and fallopian tubes in infertile women at Abakaliki, Nigeria. Niger J Clin Pract. 2008;11(3):211-5.

Bukar M, Mustapha Z, Takai UI, Tahir A. Hysterosalpingographic findings in infertile women: A seven year review. Niger J Clin Pract. 2011;14:168-70.

DOI: 10.4103/1119-3077.84008.

Bello TO. Tubal abnormalities on hysterosalpingography in primary and secondary infertility. West Afr J Med. 2006;25(2):130-3.

Obejide AO, Ladipo OA, Otolorin FO, Makamagola JD. Infertility in Nigerian women. A study of related physiological factors. J Obst Gynaecol East Cent Afr. 1986;613.

Kiguli-Malwade E, Byanyima RK. Structural findings at hysterosalpingography in patients with infertility at two private clinics in Kampala, Uganda. Afr Health Sci. 1994;4(3):178-81.

Elsie KM, Rosemary KB. Structural finding at hysterosalpingography in patients with infertility at private clinic in Kampala Uganda. Afr Health Sci. 2004;4: 178-81.

Kitila T. Infertility investigation, sociodemographic characteristics and dropouts of infertile women at family guidance association in Ethiopia. Ethiop Health Dev. 2000;14:127-34.

Daniel A, Yewebdar N. Evaluation of the fallopian tubes in infertile women by hysterosalpingography in Tikur Anibessa Hospital, Addis Ababa, Ethiopia. Int J Nurs Midwifery. 2011;3(11): 178-81.

Nwankwo NC, Akani CI. Pattern of hysterosalpingographic findings in infertility in Port Harcourt. West Afr J Radiol. 2005;12:15-9.

Mgbor SO. Pattern of hysterosalpingographic findings in gynaecological patients in Enugu. Niger Med J. 2006;47:14-6.

Adetiloye V. Hysterosalpingography in investigation of infertility: experience with 248 patients. West Afr J Med. 1992; 12(4):191-6.

Akinola RA, Akintola OI, Fabamwo AO. Pattern of genital tract abnormalities on hysterosalpingography in infertile patients in Ikeja, Nigeria. Niger Postgrad Med J 2009; 16(1):31-4.

Udobi SI, Aronu ME. Hysterosalpingographic findings in women with infertility in Awka, Anambra State, South-East Nigeria. Niger J Surg Sci. 2017;27(2):47-50.

DOI: 10.4103/njss.njss_3_18

Eze CU, Ohagwu CC, Abonyi LC, Njoku J, Iruhe N, Igbinedion FO. A spectrum of hysterosalpingographic findings in infertile women in Benin City Nigeria. J Reprod Infertil 2013;4(2):13-8.

DOI: 10.5829/idosi.jri.2013.4.2.7692.

Makwe CC, Ugwu AO, Sunmonu OH, Yesuf-Awesu SA, Ani-Ugwu NK, Olumakinwa OE. Hysterosalpingography findings of female partners of infertile couple attending fertility clinic at Lagos University Teaching Hospital. Pan Afr Med J. 2021;40;223.


Philips CH, Benson CB, Ginsburg ES, Frates MC. Comparison of uterine and tubal pathology identified by Transvaginal sonography, Hysterosalpingography, and hysteroscopy in female patients with infertility. Fertil Res Pract. 2015;1(1): 1-6.

DOI: 10.1186/s40738-015-0012-3

Maheshwari A, Hamilton M, Bhattacharya S. Effect of female age on diagnostic categories of infertility. Hum Reprod Oxf Engl. 2008;23(3):538-42.

DOI: 10.1093/humrep/dem431