Abstract
Author(s): Batool Abdulwahid Hashim Alkhalidi*, Mays Sabah Al-saadi, Shaymaa Raouf Tawfeeq, Amal Muner Mubarak, Fawz Alaa Alikhan, Adnan A Al-Bdairi, Zainab Abdulkhadhim Fatnan
Background: Uterine factor is a difficult contribution to female infertility that may seem like a hitch to gynecologists since it might compromise treatment outcomes by creating a hostile environment for embryo implantation, placentation, and fetal growth. When early tests show an abnormal uterine cavity, several institutions use hysteroscopy to diagnose and selectively treat diseases before giving IVF. Endometrial atrophy, synechiae, endometritis, polyps, FIGO 0-2 myomas, adenomyosis, septa, and other congenital anomalies are among the most common hysteroscopic findings, and this study was designed to map their distribution and disparity among patients. Objectives: This study's objective is to is to survey and analyses types and frequencies of occurring of some hysteroscopy-detected uterine pathologies and the conception rate of primary and secondary infertile women who underwent hysteroscopic intervention to point the highest pregnancy rates of either infertile group. Methodology: In the department of obstetrics and gynecology at the medical college of kufa university, this retrograde descriptive analysis was carried out for 100 infertile females’ cohort attended Al Zahra Teaching Hospital affiliated to Kufa university in Annajaf Al Ashraf province in Iraq over the period from Feb.2020 to June 2022, who underwent hysteroscopy intervention after written informed consent for assessment and or treatment of uterine factor for their primary or secondary infertility. Results: Out of 100 patients included in the study, 66 (66%) presented with primary infertility and 34 (34%) presented with secondary infertility. Normal hysteroscopy were reported in 31 (31%) women, while intracavitory pathologies detected in the other 69 (or 69%) cases, these included endometrial polyp (48%) and uterine septum (26%), submucosal mayoma (14.5%), intrauterine synechiae (7%) and isthmocele (4%). In the patients with primary infertility, the abnormal hysteroscopic findings were reported in 41 (62%) women, in whom, the most common observed abnormality was endometrial polyp (51%), uterine septum (31%), and submucosal mayoma (14.5%). In patients with secondary infertility, the abnormal hysteroscopic findings were reported in 28 (82%) women and these were distributed as follow, endometrial polyp (43%) and uterine septum (18%), submucosal mayoma (14%), intrauterine synechiae (14%) and isthmocele (10%). The conception rate after treatment of abnormal uterine cavity pathology in primary and secondary infertile women were 29% and 39% respectively. Conclusion: given the results of the study, hysteroscopy should be strongly advised as a useful component in the management work up of infertile women particularly when intracavitery pathology is suspected by preliminary tests.