A histomorphological pattern analysis in endometrial biopsies of infertile woman

Abstract

Introduction: Infertility is an agonising problem to many couples, giving them a sense of hopelessness. The hormonal alterations gives rise to various histological patterns in endometrium. Aims and Objective: To know the various morphological patterns of endometrium in females presenting with infertility (primary/secondary) Materials and Methods: A cross-sectional study in which 237 cases of endometrial biopsies were reviewed along with clinical data, in infertile woman (primary/secondary) from January 2016 to December 2018. The results were analysed and interpreted. Results: Of the 237 biopsies, 196 cases (82.7%) were of primary infertility and 41 cases (17.3%) of secondary infertility. Overall mean age was 28.3 years. The most common endometrial pattern was secretory phase (35.86%) followed by proliferative phase (30.8%). Disordered proliferative phase was seen in 17.7% cases. There were 23 cases of simple cystic hyperplasia and one case of complex hyperplasia. 5 cases each of polyp and tuberculous endometritis were diagnosed and two coincidental cases of endometrial carcinoma. One case was reported as Arias-Stella reaction. Conclusion: Secretory phase of endometrium was the most common morphological pattern which suggests that despite of ovulation there could be other causes that might have led to this ailment. This study also proposes that endometrial biopsies can be used as a primary diagnostic tool especially in cases of unexplained infertility that could be due to tuberculosis or polyps. Keywords: Endometrial biopsy, Infertility, Tuberculous endometritis.