Abnormal hysteroscopy findings among a cross section of infertile Nigerian women

Abstract

Background: Intrauterine lesions are important causes of infertility. This study aims to evaluate the abnormal findings at hysteroscopy among infertile women seen in 2 new Fertility/Gynaecological Endoscopy units in Nigeria.

Methods: A prospective study of 159 infertile women who had diagnostic hysteroscopy in Nnamdi Azikiwe University Teaching hospital Nnewi and Holy Rosary Specialist Hospital, Onitsha to evaluate the intrauterine lesions seen. Data analysis was done with STATA software, version 12.0 SE (Stata Corporation, TX, USA).

Results: Secondary infertility was the major type of infertility seen in 56.6% (n = 91) of cases and the mean  duration of infertility was 4.3+/‑ 2.8 years. The indication for hysteroscopy was routine evaluation for infertility in 83.6% cases (n = 133). One hundred and twelve (70.4%) of the women had abnormal findings at hysteroscopy. The lesions detected were intrauterine adhesions (47.8%; n = 76), endometrial polyps (17.6%; n = 28), submucous fibroids (11.9%; n = 19) and mullerian duct abnormalities (10.7%; n = 17). Other findings were lost intrauterine copper devices (IUCD; 6.3%, n = 10), embedded fetal bone (2.5%; n = 4) and incarcerated omentum (1.9%; n = 3). Intrauterine adhesions were mainly moderate (40.8%; n = 31) and mild (34.2, n = 26) in severity while the submucous fibroids were mostly of type 0 (63.2%; n = 12). The commonest Mullerian abnormality seen was arcuate uterus (41.2%; n = 7).

Conclusion: There was a high prevalence of abnormal findings on hysteroscopy among the studied women mostly intrauterine adhesions, endometrial polyps and submucous fibroids. These findings indicate a need to incorporate hysteroscopy in the routine evaluation of female infertility in the region.

Keywords: Abnormal hysteroscopy, intrauterine adhesions, intrauterine pathologies, submucous fibroids