# Hysterosalpingography and Endocervical Microbial Assessment of Infertile Women in Ogun State, Nigeria

## TL;DR

This study examines the causes of infertility in Nigerian women, finding that tubal blockage and infections are common issues linked to age and duration of infertility.

## Contribution

The study provides new insights into the prevalence of tubal and uterine pathologies and genital tract infections among infertile women in Nigeria.

## Key findings

- Tubal pathology was the most common issue, with tubal blockage at 82.5% and hydrosalpinx at 17.5%.
- Older women with tubal pathology were 2.01 times more likely to be infertile than younger women.
- Genital tract microbial infections were found in 33.9% of high vaginal and 22.2% of endocervical swabs.

## Abstract

Infertility is a global health issue with varying etiology. This study determined the prevalence and pattern of tubal and uterine pathologies with genital tract microbial infection among infertile women in Ogun State, Nigeria.

A cross-sectional study was conducted in a year among 230 infertile women aged 20 years and above scheduled for hysterosalpingography (HSG). Samples for high vaginal and endocervical swabs were analyzed as part of the study.

The mean age was 34.65 (6.18) years, and the age group 30 – 39 years had the highest frequency of infertility. The mean duration of infertility was 4.93 (3.88) years, and secondary infertility (77.8%) was higher than primary infertility (22.2%). Tubal pathology was the most common (36.1%), followed by uterine pathology (30.0%), where the tubal blockage was 82.5% and hydrosalpinx was 17.5%. There were 57 (54.8%) and 47 (45.2%) patients with single and bilateral tubal blockage, respectively. Hydrosalpinx was observed in four (20%), nine (45%), and seven patients (35%) with a right, left and bilateral distribution, respectively. Univariate regression analysis showed older women with tubal pathology were 2.01 times more likely to be infertile than the younger patients (95% CI: 1.042 – 4.100, p = 0.005), and patients with longer duration of infertility were 1.1 more likely to be infertile than patients with shorter infertility duration (95% CI: 0.995 – 1.187, p = 0.010). Of the microbes, 33.9% and 22.2% were isolated in the high vaginal and endocervical swabs of participants with tubal pathologies.

Increasing age, infertility duration, and genital microbes are significant risk factors for tubal infertility; hence, their prompt evaluation is essential.