ABSTRACT
Studies have shown that women of childbearing age in sub-Saharan Africa who desire to have children are facing higher rates of secondary infertility compared to the global average. This study aims to evaluate the significance of hysterosalpingography (HSG) and ultrasonography (US) in the treatment of infertility among women of reproductive age in Rivers State, Nigeria, by examining the findings from HSG and US regarding the myometrium, endometrium, ovaries, and fallopian tubes of the participants. The study used a Mindray ultrasound machines, with transducers (probes) operating at frequencies of 3.5MHz-7MHz and 5-12MHz (3C5A and L13-3), along with ultrasound gel. Data analysis was conducted using Microsoft Excel version 16 and SPSS (Statistical Package for the Social Sciences) version 22. The findings related to the endometrium indicate a moderate level of agreement between US and HSG. The discrepancies primarily occurred in instances where US identified focal intracavitary lesions that were not clearly visible on HSG, or where HSG indicated an irregular cavity contour without a corresponding discrete correlate on US. Additionally, myometrium findings demonstrated a fair to moderate level of agreement. US was found to be superior in identifying leiomyomas and features indicative of adenomyosis, while HSG only revealed abnormalities indirectly when the uterine cavity was distorted. The ovarian findings showed a poor level of agreement between US and HSG. US, particularly transvaginal ultrasound, effectively visualized ovarian morphology and detected functional cysts or masses, whereas HSG had minimal diagnostic value for ovarian pathology. There was a significant level of agreement between both imaging modalities in assessing fallopian tube patency or blockage, with HSG remaining the gold standard for evaluating tubal patency. In summary, US offered a more comprehensive evaluation of the endometrium, myometrium, and ovaries, while HSG proved to be the most effective for assessing fallopian tube patency. The complementary functions of these imaging methods underscore the importance of their incorporation in fertility assessments.
References
- [1] World Health Organization (WHO). Infirtility. WHO Publication Geneva. Infertility. Geneva WHO. 2020
- [2] Ekpor E, Brobbey SS, Kumah CY, Akyirem S. Experience of infertility-related stigma in Africa: a systematic review and mixed methods meta-synthesis. Int Health. 2025;17(6):903-913.
- [3] Gedef GM, Taye EB, Mohammed OY, Abegaz MY, Asratie MH, Andualem F. Prevalence of infertility and its risk factors in Sub-Saharan Africa: a systematic review and meta-analysis. Contracept Reprod Med. 2025;10(1):73.
- [4] Kassie AT, Zegeye AF, Bazezew AM, Mamo EY, Gebru DM, Tamir TT. Determinants of pressure to conceive among reproductive age women in Sub-Saharan Africa: A multilevel analysis of recent Demographic and Health Surveys in five countries. PLOS Glob Public Health. 2025; 5(2): e0004244.
- [5] Esan DT, Nnamani KQ, Ogunkorode A, Muhammad F, Oluwagbemi OO, Ramos CG. Infertility affects the quality of life of Southwestern Nigerian women and their partners. Int. J. Afr. Nurs. Sci.2022;17: 100506
- [6] Carson SA, Kallen AN. Diagnosis and Management of Infertility: A Review. JAMA. 326(2021):65-76.
- [7] Adedigba JA, Idowu BM, Hermans SP, Ibitoye BO, Fawole OA. The relationship between hysterosalpingography findings and female infertility in a Nigerian population. Pol J Radiol. 2020;85:e188-e195.
- [8] Jimah BB, Gorleku P, Baffour Appiah A. Hysterosalpingography Findings and Jimah Ratio of the Uterine Cavity in Women with Infertility in Central Region, Ghana. Radiol Res Pract. 2020;2020:6697653.
- [9] 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.
- Ombelet W, Onofre J. IVF in Africa: what is it all about? Facts Views Vis Obgyn. 2019;11(1):65-76.
- Larsen U, Hollos M, Obono O, Whitehouse B. Suffering infertility: the impact of infertility on women’s life experiences in two Nigerian communities. J Biosoc Sci. 2010;42(6):787-814.
Download all article in PDF
