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

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