Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 12 , ISSUE 1 ( January-February, 2020 ) > List of Articles

Original Article

Hysteroscopic Evaluation in Infertility: Bangladesh Perspective

Maruf Siddiqui, Nusrat Ghafoor, Fahmida Naznine, Rusmila S Abdullah, Towhid A Chowdhury

Citation Information : Siddiqui M, Ghafoor N, Naznine F, Abdullah RS, Chowdhury TA. Hysteroscopic Evaluation in Infertility: Bangladesh Perspective. J South Asian Feder Obs Gynae 2020; 12 (1):7-9.

DOI: 10.5005/jp-journals-10006-1740

License: CC BY-NC 4.0

Published Online: 02-11-2020

Copyright Statement:  Copyright © 2020; The Author(s).


Abstract

Aims and objectives: Hysteroscopy is now accepted as a gold standard method not only to access the uterine cavity but also to make therapeutic interventions for restoring the endometrial environment required for pregnancy. Uterine factors can compromise the fertility rate in infertility treatment or in assisted reproduction. This prospective study is done to diagnose different intrauterine pathologies responsible for subfertility in Bangladeshi population. Duration: November 2017 to August 2019 Setting: Department of Infertility and Reproductive Medicine, Anwer Khan Modern Medical College, Dhaka, Bangladesh. Study population: A total of 273 patients who had undergone hysteroscopy as a part of their infertility workup were included. Patients with spontaneous ovulation, anovulatory patients who underwent at least six cycles of documented successful ovulation induction, and patients with suspected intrauterine pathology in transvaginal sonography (TVS) were the subjects for this study. All of them underwent hysteroscopy with laparoscopy simultaneously. Patients with both primary and secondary infertility were included in the study. Materials and methods: Hysteroscopy was performed in a standard gynecological operation theater setup under general anesthesia (G/A). A 2.9-mm 30° telescope (Karl Storz) with a 5-mm continuous-flow operative sheath was used in all the cases. Any pathological findings during the procedure were documented. However, different therapeutic modalities, such as polypectomy, complete or partial resection of the septum, or tubal cannulation, were all performed in the same time whenever indicated. A prestructured questionnaire was used to collect the data following hysteroscopy. All the data were then processed and analyzed using the computer software: statistical package for social sciences (SPSS). The test statistics used to analyze the data were descriptive statistics and the Chi-square (χ2) test. The level of significance was set at 0.05 and the p value of <0.05 was considered significant. Summarized data were presented in the form of tables and figures with due statistical interpretation. Results: Causes of subfertility found on hysteroscopy were endometrial polyp (n = 27), endometritis (n = 15), uterine synechiae (n = 24), blocked tubes (n = 30), uterine septum (n = 7), bicornuate uterus (n = 3), cervical stenosis (n = 2), and submucosal fibroids (n = 1). Recommendations: It is therefore recommended to practice routine hysteroscopy with concurrent laparoscopy in all cases of primary and secondary subfertility in Bangladeshi population.


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