Evaluation of Cytogenetic Damage Induced during Hysterosalpingography Procedure: A Cross-sectional Study

Abstract

Introduction: Hysterosalpingography (HSG) is a radiographic procedure used to visualise the fallopian tubes and uterine cavity by injecting a contrast medium, commonly employed for diagnosing infertility cases. However, due to the associated radiographic and fluoroscopic exposure, there is an increased risk of chromosomal damage to the gonads. Aim: To investigate the impact of radiographic and fluoroscopic exposure on chromosomal integrity in peripheral blood lymphocytes using the Cytokinesis Blocked Micronucleus (CBMN) assay. Materials and Methods: This cross-sectional time-bound study included 10 patients (n=10) scheduled for HSG procedures at the Department of Radiology, Justice KS Hegde Hospital, Mangaluru, Karnataka, India from April 2021 to March 2022. Following radiation exposure, the CBMN assay was conducted to evaluate chromosomal damage in both test and control group blood samples. Blood samples from healthy donors were divided into three cryo vials, with one serving as the control and the remaining two exposed to radiation at the entrance and exit areas during the HSG procedure. The data were expressed as mean±Standard Deviation (SD). A p-value <0.05 was considered statistically significant. The analysis was performed using Statistical Package for Social Sciences (SPSS) version 20.0. Results: A statistically significant (p<0.05) increase in biological damage was observed when comparing the Micronucleus (MN) frequency of the test groups (entrance=0.022±0.005 and exit group=0.0172±0.005) with the control group (0.006±0.003). Additionally, a decrease in MN frequency was noticed within the test groups, particularly in the exit group, although the results were not statistically significant (p=0.066). Conclusion: The HSG is an effective clinical diagnostic technique. However, the present study indicates a potential risk of chromosomal damage associated with the procedure, emphasising the need for judicious use of radiation exposure during HSG.