Hysterosalpingographic tubal abnormalities and HIV infection among Black women with tubal infertility in sub-Saharan Africa

Background: Tubal factor remains a common cause of infertility. The association of HIV infection and tubal infertility is a cause for concern. Objective: To determine hysterosalpingographic tubal abnormalities and HIV infection among patients with tubal infertility. Results: Over a 4-year period, 207 patients were analyzed. Of these, 174 (84.1%) presented with secondary infertility and 33 (15.9%) with primary infertility. The patients' age range was 21-48 years and mean age was 36.2 years. One hundred and two (49.3%) patients had a history of induced abortion. Concordant bilateral tubal occlusion was found in 139 (67.2%) patients while 68 (32.8%) had discordant bilateral tubal occlusion. Of the 414 fallopian tubes studied, proximal tubal occlusion was found in 66 (15.9%) cases and distal tubal occlusive pathology occurred in 348 (84.1%). An HIV positivity rate of 13.5% was recorded. Distal tubal occlusion with hydrosalpinx was more associated with HIV infection in this series. Conclusion: A high HIV positivity rate was recorded among the patients with tubal infertility compared to the general population. There is prepondence of distal tubal occlusion in infertile women with tubal factor.