Radiological Evaluation of Uterine Tubes in Infertile Women with Previous Pelvic Surgery

Abstract

Background:Infertility is a disease that affects 8%–12% of couples at their reproductive age. Tubal factors account for 20%–30% of infertility cases. Tubal infertility can be caused by infections, endometriosis, and complications from previous abdominopelvic surgery. Objectives:The objective of the study is to determine the impact of pelvic surgery on future fertility by examining the fallopian tubes for any potential damage using a hysterosalpingography (HSG) examination. Materials and Methods:A cross-sectional study was conducted at Nineveh Governorate, Iraq, in two clinics from March 2022 to September 2022 by examining 317 infertile females using HSG. The exam was done as part of an infertility workup. Results:The results revealed that the study included 317 infertile women patients with a mean age of 28.82 ± 6.9 years (range 17–49 years), of these, 184 patients (58.04%) with primary infertility, and 133 patients (41.95%) with secondary infertility. The years of infertility ranged between 1 and 20 years and a median of 4 years. The history of one or more previous pelvic interventions was recorded in 39 cases (12.3%). The prevalence of tubal abnormalities was noted in 23.1% of cases with previous pelvic intervention and 13.3% in other patients, with an odds ratio of 1.95 at a 95% confidence interval. Tubal abnormalities do not differ significantly according to the type of infertility, and the mean age of infertile women with tubal abnormalities is not statistically different from those with normal tubes. Conclusion:This study concludes that pelvic surgeries, particularly cesarean operations increase the risk of developing subsequent fallopian tube abnormalities and pelvic adhesions, which can lead to infertility.

Keywords

• hysterosalpingography
• infertility
• pelvic surgeries
• tubal factor
• tubal obstruction