Asymptomatic lower genital tract infections in women undergoing hysterosalpingography

SummaryWe assessed the prevalence of asymptomatic lower genital tract infections in women undergoing hysterosalpingography for investigation of infertility. Vaginal and endocervical swab specimens were collected for bedside tests and culture for diagnosing bacterial vaginosis, Trichomonas vaginalis, Neisseria gonorrhoea and Chlamydia trachomatis. Serum specimens were analysed for antibody to HIV and syphilis serology. All patients were reviewed 4 to 5 days after hysterosalpingography for evidence of pelvic infection. Bacterial vaginosis was diagnosed in 56 per cent, trichomoniasis in 18 per cent, gonorrhoeae in 3 per cent and chlamydial infection in 4 per cent. Mixed infections were found in 12 women; in nine, bacterial vaginosis with trichomoniasis; and in three, bacterial vaginosis with chlarnydial infection. Post hysterosalpingography salpingitis occurred in 8 per cent (6 of 80) of the women investigated. This study highlights the high prevalence of subclinical lower genital tract infections including sexually transmitted diseases in our patient population and recommends that all women undergoing infertility investigations be screened and treated prior to the performance of any invasive procedure such as hysterosalpingography.