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Abstract
Objective: To determine the frequency and pattern of hysteroscopic findings in women presenting with subfertility at a tertiary care hospital.
Study Design: Observational, descriptive, cross-sectional study.
Setting: Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Centre (JPMC), Karachi.
Period: Four months from December 2024 to March 2025.
Methods: The research sampling technique in this study was consecutive sampling, which is a non-probability sampling technique. The women with Primary or Secondary subfertility referred for diagnostic hysteroscopy were recruited consecutively; there were 60 women. A predesigned study proforma was utilised to gather data. After examination, a hysteroscope with a 5 mm diameter was used to perform hysteroscopy, and a systematic examination of the entire uterine cavity for abnormalities was performed. IBM SPSS Statistics was used to complete the data analysis. Descriptive statistics were calculated as mean ± SD and median (IQR) for quantitative variables. Frequencies and percentages were used to present the qualitative variables. Stratification was performed for pertinent demographic and subfertility-related parameters. Chronological relationships were tested after stratification with the Chi-square test. A p-value <0.05 was considered statistically significant.
Results: In total, there were 60 women with a diagnosis of subfertility who were assessed. Their mean age was 31.45 ± 5.62 years, while mean BMI was 24.57 ± 3.98 kg/m². Overall, there were 36 women with primary subfertility. 24 women (40.0%) had secondary subfertility. Abnormal hysteroscopic findings were found in 32 women (53.3%) among all the women who underwent hysteroscopy in the diagnostic group. The most frequently found abnormalities were endometriosis polyps. Exploratory hysterectomy also revealed other lesions, including submucous fibroids, intrauterine adhesions, uterine septum, and chronic endometritis. A total of 21 women advanced no more than 21 women at one time for therapeutic hysteroscopy. Statistically, no significant correlations were found after stratified analysis. There was no statistically significant association between any of the following and abnormal hysteroscopic results: age, BMI, subfertility type, or subfertility duration. None of the corresponding p-values were significant (p>0.05).
Conclusion: Hysteroscopy detected abnormalities in the uterine cavity in more than 50% of the subfertile participants assessed, where endometrial polyps were the most prevalent finding. Based on these findings, polyps should be included as a minimum evaluative requirement during subfertility assessments in a tertiary care setting.