FREQUENCY OF BILATERAL TUBAL OBSTRUCTION AND COMMON FACTORS LEADING TO IT AMONG WOMEN PRSESENTING WITH SECONDARY INFERTILITY

Abstract

BACKGROUND: Infertility is not uncommon in our female population as we live in a geographicalarea where the population growth rates are amongst the highest in the world. A variety of cultural normsand values force couples to enhance family. So a sensitive and dedicated efforts need to be made to lookinto the causes of secondary infertility and their treatment.OBJECTIVES: To determine the frequency of bilateral tubal obstruction and common factors leadingto it among women presenting with secondary infertility.METHODOLOGY: It was a hospital based descriptive cross sectional study conducted at thedepartment of obstetrics & gynecology Postgraduate medical institute LRH Peshawar from 8th August2011 to 8th July 2013. Data was collected by non probability consecutive sampling technique. A total of260 patients were enrolled in study. In patients presenting with secondary infertilityhysterosalphingography was performed, in those with bilateral tubal obstruction detailed history wastaken to detect, the history of instrumentation to genital tract, lower abdominal surgery or history ofPID. Laparoscopy was done in all patients with bilateral tube obstruction to confirm the diagnosis anddetermine causes.RESULTS: In this study mean age was 30 with standard deviation of ±2.12. Bilateral tubal obstructionwas found in 73(28%) of the cases, out of which history of pelvic inflammatory disease was presentin15 (21%) followed by history of instrumentation of genital tract in 11(15%) of cases. Positive historyof lower abdominal surgery was present in 4(5%) and 3(4%) patients had fibroids.CONCLUSION: Tubal pathology is one of the main causes of female infertility. A great caution isrequired in pelvic operative techniques to prevent infection and tubal damage.KEY WORDS: secondary infertility, bilateral tubal obstruction, pelvic inflammatory disease.