Hysterosalpingographic Findings in Chlamydia Trachomatis IgG-Positive Infertile Women Attending the Gynecological Clinic in Abuja. Nigeria
Iyellobu Collins Ekhaesomi and Offor Juliet Oluchukwu*
ABSTRACT
Background: Chlamydia trachomatis infection is one of the prevalent sexually transmitted infections that frequently remains asymptomatic, allowing persistent inflammation to result in tubal and endometrial damage with subsequent infertility. In resource-limited settings, where access to definitive diagnostic modalities is restricted, identifying cost-effective screening approaches to detect women at risk of upper genital tract pathology is particularly important.
Objective: To investigate the hysterosalpingography tubal and uterine findings and determine factors associated with tubal occlusion among Chlamydia trachomatis IgG–positive infertile women at the Federal Medical Centre, Abuja, Nigeria.
Methodology: This prospective cross-sectional study enrolled 130 consenting infertile women aged 15–49 years who tested positive for C. trachomatis IgG antibodies using a rapid chromatographic immunoassay kit (Acro Biotech, USA). All participants underwent hysterosalpingography (HSG) on day 10 of their menstrual cycle to assess tubal patency and uterine abnormalities. Descriptive statistics and logistic regression analysis were used to analyse factors associated with tubal occlusion.
Results: Of the 130 women, Secondary infertility accounted for 53.1% of cases. Tubal occlusion was detected in 76.9% (95% CI: 69.0–83.3) of participants, while 26.9% had uterine synechiae. Women with uterine synechiae had a fourfold increased likelihood of tubal occlusion (OR = 4.00; 95% CI: 1.68–9.52; p = 0.002). Increasing age, early sexual debut, multiple lifetime sexual partners, lower social class, and uterine synechiae were independently associated with tubal occlusion, with a p-value of ≤ 0.5.
Conclusion: A high burden of tubal and uterine pathology was observed among Chlamydia trachomatis IgG–positive infertile women. Chlamydia serology may serve as a useful adjunctive screening tool to identify women at increased risk of upper genital tract pathology before more invasive or costly investigations.
