How popular is X-ray hysterosalpingography in the investigation of infertility by radiographers and radiologists in Nigeria?

Background: Nigeria has an infertility rate of 4% to 48.1%. This health condition is the most frequently investigated in radiology departments across the country. Although ultrasound is used as first line investigation, its limited sensitivity to tubal patency has made hysterosalpingography (HSG), despite its radiation risks, as the procedure of choice.
Objective: To determine the throughput of all special investigations in the study locations with a view to ascertaining if the use of hysterosalpingography is declining or flourishing.
Methods: A retrospective extraction of data about special investigations from physical archives in the radiology department of two tertiary hospitals. Concluded special investigations between 2012 – 2014 and 2017 – 2019 were enlisted. The physical film jackets in both centers were consecutively scrutinized and the type and date of special investigation was noted.
Results: A total of one hundred and forty-eight thousand, three hundred and twenty-two (148,322) patients aged 2 days to 95 years (mean: 34.85 ± 16.61 years) passed through the radiology departments between 2012 – 2014, and 2017 – 2019. Those for special radiological investigations numbered 4,806 (3.24 %). Hysterosalpingography (n = 2.148; 44.7%) and lateral invertogram (n = 39; 0.8%) were the special investigations with the highest and least throughputs, respectively. There were five specific HSG findings and fibroid had the highest frequency (n = 683; 31.80%).
Conclusions: Hysterosalpingography is the most common special radiological procedure for investigating infertility by radiographers and radiologists in Nigeria.