Abstract

Objectives: The aim of the study was to compare the demographic, surgical and fertility characteristics of two groups of infertile women (IW) with and without intrauterine adhesion (IUA) from a diagnostic hysteroscopy. Materials and Methods: One thousand one hundred and fifteen IW were included in the study. Intrauterine examination by hysteroscopy was performed on all the subjects to enable the observation of the uterine cavity for any abnormality or pathology. Biophysical profile of IW with normal hysteroscopy were compared with those having mainly IUA as abnormal finding on hysteroscopy. Results: A total of 1115 IW were examined among whom 427 (38.3%) and 688 (61.7%) had normal and abnormal findings on hysteroscopy. Of the 688 IW with abnormal findings, 338 (49.1%) were mainly due to IUA. The mean [± SD] age (38.1 [6.37] years) of IW with normal hysteroscopy (n = 427) was significantly different (t = -5.67, df = 748.2, P = 0.000) from that (40.6 [5.80] years) of IW with IUA (n = 338). Those aged ≥ 35 years were three times more likely to present with abnormal IUA than those aged < 35 years (χ² = 38.53; P-value-0.000; OR = 3.06, 95% CI = 2.13, 4.41). Conclusions: Our results indicate that age, body mass index, and previous uterine surgery, acting independently or synergistically, are likely risk factors for the development of intrauterine adhesions among infertile women in Nigeria.

Highlights

  • Hysteroscopy is a relatively new procedure in the investigation of congenital structural abnormalities or acquired lesions that might pose fertility challenges to women in reproductive age

  • 1115 infertile women were recruited into the study of whom 350 had other abnormal findings on examination by hysteroscopy (EBH) apart from intrauterine adhesions (IUA)

  • A comparative analysis of Age, Body Mass Index, Type of Infertility and history of previous uterine surgery was conducted between the infertile women (IW) who had normal finding on EBH and those who had abnormal findings on EBH, IUA (n = 338; cases), totaling 765 IW

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Summary

Introduction

Hysteroscopy is a relatively new procedure in the investigation of congenital structural abnormalities or acquired lesions that might pose fertility challenges to women in reproductive age. About two decades ago hystero-salpingography (HSG) was the available procedure for assessing the uterine cavity but of recent, the use of hysteroscopy. Many authorities on assisted fertility are of the opinion that hysteroscopy is a more accurate tool because of the high false-positive and false negative rates of intra uterine abnormality with HSG [2]. While some authors argue that abnormal uterine bleeding (AUB) is the most common indication for hysteroscopy [3,4], others regard hysteroscopy in the management of infertile women without other diagnosed or doubtful intrauterine pathologies as still a matter of debate [5]. The prevalence of abnormal uterine finding is estimated to be 34% to 62% in infertile women [9]

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