Hysterosalpingographic evaluation of human immunodeficiency virus-infected and uninfected infertile women.

BACKGROUND

Hysterosalpingography (HSG) is an outpatient fluoroscopy-guided procedure that evaluates the uterine cavity and fallopian tube patency in infertile women. Its cost-effective use is being challenged with the human immunodeficiency virus (HIV) burden in KwaZulu-Natal, which characteristically affects multiple organs.

OBJECTIVES

The aim of this study was to describe the HSG findings in a group of HIV-infected and uninfected infertile women.

METHOD: This was a retrospective study conducted over a 4-year period (2012-2016) in which the HSG images and reports of 178 infertile patients from records of the Radiology Department were re-reviewed for abnormalities of the cervix, uterus and fallopian tubes. Their clinical data and radiological findings were entered into a pre-coded data sheet and analysed.

RESULTS

The frequency of HIV infection amongst patients with infertility was found to be 32.6%. Forty-four patients were on antiretroviral therapy at the time of the HSG examination, whereas three had not yet started treatment. From the 178 HSG reports, 109 (61.2%) were abnormal. Tubal pathologies were the most common abnormalities, accounting for 79 of the 109 cases and was higher in HIV-infected women than in HIV-uninfected women (p = 0.001). Uterine filling defects were demonstrated in 13 of the 109 cases. There were two cases of cervical abnormalities.

CONCLUSION

The study demonstrated that tubal abnormalities were the most common findings amongst infertile women undergoing HSG and occurred predominantly in HIV-infected patients.