A Study of Endometrial Etiological Spectrum in Causation of Infertility in Gulberga, Karnataka

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.