title: Male factor infertility may be associated with a low risk for tubal abnormalities.
abstract: This study assessed the association of an abnormal hysterosalpingography (HSG) with clinical characteristics and infertility investigation results in 1359 women who underwent HSG as part of their infertility work-up. A normal HSG result was found in 1031 tests (75.9% of all HSG tests). Significantly positive predictors of tubal occlusion on multivariate analysis were longer duration of infertility (OR 1.072, 95% CI 1.006-1.143), previous pelvic inflammatory disease (PID; OR 2.172, 95% CI 1.176-4.008), extrauterine pregnancy (EUP; OR 15.74, 95% CI 6.66-37.16) and any abdominal surgery (except Caesarean section; OR 1.503, 95% CI 1.120-2.017) and negative predictor was male factor infertility (OR 0.543, 95% CI 0.401-0.735). The presence of male factor decreased the risk of tubal abnormality from 32.4% to 15.6% (P<0.001) in women with known risk factors for tubal abnormalities (previous PID, EUP or abdominal surgery) and from 17.8% to 11.5% (P=0.01) in women at low risk for tubal abnormalities. As the risk for tubal factor is approximately 1:10 in patients with male factor infertility without other risk factors, the practice of postponing HSG until after one or two treatment cycles may be considered.
authors.affiliation: Fertility Clinics, Ashdod and Holon Women's Health Centers, Clalit Health Services, Rabin Medical Center, Petach Tikva, Israel. j_farhi@yahoo.com
authors.forename: Jacob
authors.initials: J
authors.lastname: Farhi
authors.forename: Roy
authors.initials: R
authors.lastname: Homburg
authors.forename: Avi
authors.initials: A
authors.lastname: Ben-Haroush
mesh_terms: D053627:Asthenozoospermia / Q000473:pathology*; D005187:Fallopian Tubes / Q000002:abnormalities*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007246:Infertility / Q000175:diagnosis*; D008297:Male; D015999:Multivariate Analysis; D009845:Oligospermia / Q000473:pathology*; D011247:Pregnancy; D012307:Risk Factors; D013997:Time Factors