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Background:
Subfertility is an important condition with widespread socio-cultural implications. Its
prevalence has been increasing with structural anomalies of the female genital tracts
being one of the biggest contributors. HSG studies are quintessential in diagnosing these
and so invaluable in radiological work up of subfertile females. Few studies that are
radiologically based have been done in Kenya hence such patterns as seen on HSG are
not well known at MTRH.
Objective: To determine patterns of structural defects as seen on HSG and its association
with demographic characteristics and subfertility sub types.
Research design & Methodology: This was a cross-sectional study done in the
Radiology and Imaging department of MTRH. The study population was subfertile
females. A sample size of 141 subfertile females was determined using fishers formula.
Consecutive sampling was done. Non consenting or females with contra indications to
HSG were not included. Data was analyzed using STATA version 12. Fischer’s exact and
chi-square tests to determine associations.
Results: Median age was 31 (IQR: 23-40) years. Most respondents, 131(93%) were
married. Majority, 125(88.6%) had minimum level of secondary education. Primary
subfertility seen in 40(28%) while secondary subfertility in 101(72%). Participants with
primary subfertility presented at a mean duration of 4 years. Older participants had longer
subfertility duration. A minority, 8(6%) had previous pelvic surgery; this wasn’t
statistically significant as an associated factor for subfertility (p 0.616). Contraceptives
had been used by 78(52%), with no significance noted toward having utero-tubal defects
(P=0.078). Normal uterine findings were seen in 122(87%). Filling defects were the
commonest uterine abnormality. Tubal blockage was common, present unilaterally in
18% and bilaterally in 27%. No risk of increased tubal defects was seen in either primary
or secondary subfertility over the other. Older age was linked to presence of uterine
abnormalities. There was no significant associations between education level,
employment and type of subfertility or between contraceptive use and previous pelvic
infection with occurrence of utero-tubal defects.
Conclusions. Most patients were married and literate. Secondary subfertility was the
commonest type. Tumors were the commonest uterine pathology and distal tubal
occlusion the commonest tubal defect. There is a positive relationship between age and
development of uterine defects.
Recommendations There’s need for similar but larger studies to help determine
associations of these patterns with a view of establishing proper interventions. |
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