Hysterosalpingogram findings among subfertile women undergoing assisted reproductive technology

Dania Al-Jaroudi,1 Abeer Abdullah Aldughayyim,2 Wadha Suliman Alshamry,3 Ahlam Saud Alrashidi,3 Ahmed A Bahnassy4 1Reproductive Endocrine and Infertility Medicine Department, King Fahad Medical City, Riyadh, Saudi Arabia; 2AL Maarefa College King Khaled Branch, Ad Diriyah for Science and Technology MCST, Riyadh, Saudi Arabia; 3Faculty of Medicine, King Khalid Hospital, Hail, Saudi Arabia; 4Faculty of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia Purpose: The objectives of our study included comparing reproductive histories and causes of infertility between patients with and without a hysterosalpingogram (HSG) investigation, and summarizing the prevalence and extent of tubal abnormalities among patients who underwent HSG. Outcomes following assisted reproductive technology (ART) were compared between HSG and non-HSG groups. Materials and methods: A cross-sectional study was conducted to review the medical records of 200 Saudi women with subfertility. In addition to information on HSG, patient data extracted included age, body mass index (BMI), infertility duration, miscarriage experience, parity, cause of infertility, and history of previous surgery, ectopic pregnancy, endometriosis, tubal surgery, pelvic inflammatory disease (PID), in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), pregnancy, and live birth. Results: One hundred and ninety six (98.0%) patients had either IVF (n=18; 9.0%) or ICSI (n=178; 89.0%) performed; ICSI was performed in 157 (90%) and 21 (81%) patients. Of the 12 women with tubal factor who did not undergo HSG, 3 (25.0%) became pregnant after ART, 8 (66.7%) did not, and the status of 1 (8.3%) is yet unknown. Conclusions: Our study aimed to contribute to resolving the debate regarding the continuing role of HSG in an environment where ART has become established as a successful approach to treat infertility. Most of the HSGs were done as per the attending physician’s discretion, and not according to any specific policy. Keywords: assisted reproductive technology, hysterosalpingogram, intracytoplasmic sperm injection, infertility, in vitro fertilizatio