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This cross-sectional study evaluated the prevalence of intrauterine adhesions among 980 women with primary or secondary subfertility using diagnostic hysteroscopy. The results indicated that 18.7% of patients with abnormal hysteroscopic findings had adhesions, with a significantly higher occurrence in those with secondary subfertility. The authors concluded that hysteroscopy serves as a vital diagnostic and therapeutic tool for improving fertility outcomes through adhesiolysis. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.
Abstract
Background: Sub-fertility is a growing reproductive health concern. While common causes like PCOS and endometriosis are well-known, intrauterine adhesions (IUAs) remain an under recognized contributor. Intrauterine adhesions, often resulting from uterine surgeries, can impair fertility and are best diagnosed through hysteroscopy. Objective: To observe the role of diagnostic hysteroscopy in the evaluation of intrauterine adhesion in sub fertile women. Study type, settings & duration: This cross-sectional study was conducted at Department of Gynecology and Obstetrics, Hameed Latif Hospital, Lahore from June 2023 to June 2024. Methodology: A total of 980 women aged 20 to 50 years, of which 620 suffered from primary subfertility and 360 from secondary subfertility. All patients with abnormal findings on hysteroscopy were noted to find the ratio of intra uterine adhesion which was then categorized into mild, moderate and severe IUAs. The Pearson Chi-Square test was performed. The level of significance was 5%. Results: The mean age of patients was 34.31±5.12 years and 51.1% of them suffered from subfertility for more than 5 years. Total 310 (31.63%) women had abnormal hysteroscopy of which 58/310 (18.70%) patients had adhesion in cavity. Adhesions remained to be significantly high (p-value =0.01) among secondary type of subfertility. Conclusion: Hysteroscopy play an important role as both diagnostic and therapeutic tools in the subfertility treatment. Diagnosing and treating intrauterine adhesions is essential for improving fertility outcomes. Positive results regarding pregnancy and live birth rates can be predicted after hysteroscopic adhesiolysis.
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Pakistan Journal of Medical Research (Jul 2025)
The Role of Diagnostic Hysteroscopy in Evaluation of Intrauterine Adhesions in Infertile Females
Abstract
Background: Sub-fertility is a growing reproductive health concern. While common causes like PCOS and endometriosis are well-known, intrauterine adhesions (IUAs) remain an under recognized contributor. Intrauterine adhesions, often resulting from uterine surgeries, can impair fertility and are best diagnosed through hysteroscopy. Objective: To observe the role of diagnostic hysteroscopy in the evaluation of intrauterine adhesion in sub fertile women. Study type, settings & duration: This cross-sectional study was conducted at Department of Gynecology and Obstetrics, Hameed Latif Hospital, Lahore from June 2023 to June 2024. Methodology: A total of 980 women aged 20 to 50 years, of which 620 suffered from primary subfertility and 360 from secondary subfertility. All patients with abnormal findings on hysteroscopy were noted to find the ratio of intra uterine adhesion which was then categorized into mild, moderate and severe IUAs. The Pearson Chi-Square test was performed. The level of significance was 5%. Results: The mean age of patients was 34.31±5.12 years and 51.1% of them suffered from subfertility for more than 5 years. Total 310 (31.63%) women had abnormal hysteroscopy of which 58/310 (18.70%) patients had adhesion in cavity. Adhesions remained to be significantly high (p-value =0.01) among secondary type of subfertility. Conclusion: Hysteroscopy play an important role as both diagnostic and therapeutic tools in the subfertility treatment. Diagnosing and treating intrauterine adhesions is essential for improving fertility outcomes. Positive results regarding pregnancy and live birth rates can be predicted after hysteroscopic adhesiolysis.
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