A Study of Endometrial Etiological Spectrum in Causation of Infertility in Gulberga, Karnataka
Subscribe/Renew Journal
Background: Infertility is world wide problem and is defined as inability of couple to achieve conception after one year of unprotected coitus. The purpose of investigation in infertile couple is to assess chance of achieving pregnancy and to identify treatable factors.
Aims:
1)To determine causes of primary and secondary infertility by endometrium patterns.
2)To assess importance of luteal phase deficiency in infertility.
3)To determine endometrial glycogen content and its possible correlation with infertility.
4)To determine incidence of tubercular endometritis as an etiological factor.
Settings and design: It is 5 year prospective study . Females complaining of primary or secondary infertility were included.
Materials and Method: During our 5 years study (July 2004 to June 2009), we received 230 endometrial currettings (178 cases-primary infertility and 52-secondary infertility) in Pathology Department, at M.R.Medical College, Gulbarga. Routine histopathological processing and staining was done with hematoxylin & eosin. Periodic acid Schiff stain was done for 50 cases of infertility and 25 cases of proved fertility (control).
Results and Conclusion: Histopathologically, endometrium showed secretory phase- 149, proliferative (anovulatory cycles)-53, tubercular endometritis-7 and endometrial hyperplasia-15.Luteal phase defect (LPD) was observed in 39 cases with glycogen deficiency (43.8%).Thus, anovulatory endometrium, LPD and endometrial hyperplasia formed major etiology, whereas endometriosis and tuberculosis formed minor group. Glycogen deficiency was seen mainly in LPD. Thus, endometrial biopsy is an important investigation in developing countries where expensive, immunological and hormonal assays are not easily available or affordable.
Keywords
- Dawn C.S text books of Gynecology,Contraception & Demography 14th edition 2003,11;103-114.
- Howkins & Bourne Shaw’s text books of Gynecology 12th edition 1999, 13;152-168.
- Leon speroff, Marc AF .Clinical gynecologic endocrinology and infertility:6th edition, :Lippincot Williams and Wilkins 1999.26;1013- 1037.
- Drissen P.J Holwedra .Putte J Kremmer:The significance of dating on endometrial biopsy for the prognosis of the infertile couple. Int .J. Fertile 1980;25:112.
- Jones G.S the luteal phase defect fertile steril 1976;27:351
- Noyes R. W, Hertig A. T, Rock J. Dating the endometrial biopsy. Fertile Sterile 1950; 1:3.
- Dallenbach- Hellwag, Histopathology of the endometrium. 4 edition Sprigner- Verlag 1980.
- Haines and Taylor. Obstretical and Gynaecological Pathology 1995.
- Arzac J. P. and Blanchet E.J, Clinical Endocrinology. 1948;8:315.
- Krishna Mohan V.E Basanti Nair, Sheela shenoy . A histopathological study endometrium in primary sterility .Indian J obst and Gynaec . 1993;43:581-4.
- Rameshkumar K and Thomas .J a endometrial biopsy in women with primary infertility Indian. J obst and Gynaec 1991;9:20.
- Sahmay S oral C caridogan C sentruch L Stosu T endometrial biopsy findings in infertility analysis of 12,949 cases int J Fertil Menopausal study 1995;40(6) :316
- Amarnath Bhide, Parulkar , Bhattacharya genital tuberculosis in women J obst and gynaec inaia 1987;37:576
- Zawar MP, Deshpande NM, Gadgil PA.Mahanta A.Hsitopathological study of endometrium in infertility . Indian j Pathol Microbial 2003;46 (4):630-633.
- Girish C.J A histopathological study of endometrium in infertility with special reference to its glycogen content dissertation submitted to RGUHS 2006;6:80
- Neil .S. Shastrabudhe, sharmila shinde endometrium in infertility Indian J of obst and Gynaec 2011;51:100.
- Tyagi S.P Nishant IA, Najma Abbassi, Prasad M .Shaista M.Endometrial tuberculosis J of obst and gyn of India 1977;27:935-40.
- Gupta A.N Agarwal S, Vashista K study of endometrium in infertile women. J.Obst and Gynaec India 1980;8:27
- Wentz.A.C, Endometrial biopsy in evaluation of infertility. Fertile steril 1980; 33:2.
- Michel soules, Luteal phase deficiency. The infertile women 1987; 14: 865.
- Vishnu Gopal M Raj Baveja Vatsala somont tubercular endometritis J of obst and gynaec of India 1971;21(1-3):72-77.
- Rajiv Misra S.P Sharma Mrs Jenna Mrs Nalini Pant, D.K Shrivastava female genital tract tuberculosis special reference to sterility in eastern U.P India J obst and Gynaec 1991;9:20.
- Shetty V.G endometrium in infertility .J obst and Gynec India 1959;10:139.
- Sareen P.M, Roopam Karla, S.K. Lodha, V.B Karla, Significance of endometrium glycogen in primary sterility. Indian J.Obst and Gynaec 1984; 34:877.
- Falk V, Ludriksson K, Agnon C. Genital tuberculosis in women. Am J. Obst 1980;138:933.
- Fox H, Buckely C.H, Histopathological study of endometrium in infertility cases.Recent advances in histopathology 1981.
- Hughes EC. Am. J. of Obst and Gync. 1945;49: 10-14.
- Sharma, S C.Banerjee A K: Endometrial glycogen in sterility: J Obst and Gynaec India:1984:34:1073
Abstract Views: 887
PDF Views: 0