THE ROLE OF HYSTERSALPINGOGRAPHY IN THE DIAGNOSIS OF UTERINE AND TUBE

DISEASES IN WOMEN WITH FAMILITE MEDITERRANEAN FEVER AND INFERTILITY

 

Sotskiy P.O.2, Sotskaya O.L.1,2, Ohanesyan L.R.3, Safaryan M.D.1

 

Purpose. To evaluate the role of hysterosalpingography in the diagnosis of uterine and tube diseases in women with infertility and Familial Mediterranean Fever.

Materials and methods. An observational cohort study in which a group of women (4577) of reproductive age (18-49 years old) diagnosed with Familial Mediterranean Fever was sequentially selected from the registration and information collection register of the Center for Medical Genetics, Yerevan, Armenia, for 1998-2018 years, including clinical, laboratory and genetic data of 32,000 persons of Armenian nationality, examined for the presence of mutations in the MEFV gene. Three study groups were formed: 1) The main group – 211 patients with Familial Mediterranean Fever aged 18 to 45 years (average 21.3 (6.4) years; 2) Comparison group – 127 patients with female genital tuberculosis aged from 18 to 45 years (average 28.4 (7.0) years; 3) Control group – 162 women with reproductive disorders without Familial Mediterranean Fever and female genital tuberculosis, aged 18 to 49 years (average 31.4 (7.0)). The results were processed using the SPSS Statistics 21.0 application package.

Results. Revealed pelvic adhesions/peritubal adhesions in 70.8% in group 1, in 73.3% in group 2, and in 32.6% in controls (p=0.012). The patency of the fallopian tubes was preserved in 77.1% of women with Familial Mediterranean Fever and in 69.6% in the control versus 23.3% in the 2nd group; p<0.015. In the 2nd group, pronounced structural changes in the fallopian tubes were revealed – in 53.3% versus 6.3% and 6.5% in the 1st and 3rd groups (p<0.0001) and intrauterine synechia with uterine hypoplasia – in 23.3% of patients versus 4.2% and 13.0% in the 1st and 3rd groups (p<0.01).

Conclusion. Familial Mediterranean Fever and female genital tuberculosis are characterized by an increased incidence of pelvic/peritubal adhesions. Pronounced structural changes and occlusion of the fallopian tubes, intrauterine synechia with uterine hypoplasia are significantly more common in patients with female genital tuberculosis.  Hysterosalpingography is an effective method for diagnosing infertility in patients with a high level of adhesive changes in the uterus and small pelvis.

1 - Mkhitar Heratsi Yerevan State Medical University

2 - Center for Medical Genetics and Primary Health Care,

3 - V. Avakyan Center for Medical. Yerevan, Armenia.

Keywords: familial Mediterranean fever, hysterosalpingography, tubal occlusion, infertility, female genital tuberculosis.

 

Corresponding author: Sotskiy P.O., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Sotskiy P.O., Sotskaya O.L., Ohanesyan L.R., Safaryan M.D. The role of hystersalpingography in the diagnosis of uterine and tube diseases in women with familite mediterranean fever and infertility. REJR 2022; 12(4):95-105. DOI: 10.21569/2222-7415-2022-12-4-95-105.

Received:        26.05.22 Accepted:       10.10.22