ROLE OF ENDOMETRIOSIS AS A RISK FACTOR FOR THE FEMALES WITH PRIMARY SUB-FERTILITY.

Syeda Eima Iftikhar Gardezi ,Sidra Mahmood ,Arslan Ahmad

doi:10.7176/jmpb/55-13

Abstract

Objectives; To determine the role of endometriosis among women in cases of primary sub-fertility. Material and methods; A total of 169 women having primary infertility were included in this cross-sectional study which was done from January 2018 to May 2019 at Department of Obstetrics and Gynecology, Nishtar Hospital, Multan. Complete history was taken for age, duration of infertility, duration of marriage, sexual history, history of intake of contraceptive drugs, past medical/surgical history and if patients had taken any previous treatment for fertility issues. General physical as well as systemic examination were performed by a trained doctor along with pelvic examination. Baseline investigations like ESR, FSH, LH, serum prolactin levels were done. These study cases will undergo pelvic ultrasound and laparoscopy was performed in proliferative stages of menstrual cycle. Data was analyzed by using SPSS Version 20. Results; Mean age of our study cases was noted to be 28.92 ± 4.55 years (with minimum age was 22 years while maximum age was 38 years). Family history of infertility was noted in 33 (19.5%) of our study cases. Mean duration of marriage in our study cases was noted to be 4.33 ± 1.03 years. Mean BMI of our study cases was 22.21 ± 3.01 kg/m 2 (with minimum BMI was 18 kg/m 2 while maximum BMI was 32 kg/m 2 ). Our study results have shown that obesity was present in 36 (21.3%) of our study cases. In our study, endometriosis was seen in 27 (16 %) of our study cases. Stage 1 endometriosis was seen in 4 (2.4%), stage 2 endometriosis in 6 (3.6%), stage 3 endometriosis in 8 (4.7%) and stage 4 endometriosis in 9 (5.3%) of our study cases. Conclusion; Frequency of endometriosis was high in our study. Our study results indicate that it is a common gynecological problem which usually found in patients of young and reproductive age. Laparoscopy is a minimally invasive procedure which requires minimum time of hospitalization and minor post-operative discomfort in diagnosis of endometriosis. Laparoscopic procedures in women with infertility should be employed earlier as they are relatively less invasive, convenient and more accurate tool for diagnosis. There is a dire need to bring about awareness among infertile women to consult infertility clinics at proper time. It emphasizes the need to recognize the outcomes of laparoscopic procedures for management and diagnostic purposes. Keywords; Primary infertility, endometriosis, laparoscopy. DOI : 10.7176/JMPB/55-13 Publication date :May 31 st 2019

Highlights

Introduction; Infertility has been implicated with significant increase in personal sufferings and distress of family life
According to United Nations Organization (UNO) "Reproductive health is a state of complete physical mental and social well-being and not merely the absence of disease or infirmity in all matters relating to the reproductive system and to its functions and processes"
Different rates of endometriosis have been reported with great variation in their proportions such as; 0.7 – 11% those visiting health care facilities, 2-22% among those in surgical sterilizations, around 50 % among infertile females and 5-75 % in females presenting with chronic pelvic pain[3,4,5]

Summary

Introduction

Introduction; Infertility has been implicated with significant increase in personal sufferings and distress of family life. Endometriosis has been reported to cause issues relating to www.iiste.org the fertility, painful menstrual cycles and sexual intercourse. Endometriosis was 12.5% in infertile women who underwent laparoscopy[1] while another study from Pakistan reported 16.8% frequency of endometriosis with laparoscopy.[8] Results; Our study comprised of 169 women with primary infertility meeting inclusion and exclusion criteria of our study.

Results

Conclusion