Hysteroscopic evaluation of post abortive infertile females

Objectives: To study the hysteroscopic findings in cases of secondary infertility following abortion compared to cases with primary infertility. Methods: This was a case control study of 200 selected infertile women undergoing diagnostic hysteroscopy as a part of their infertility work-up. These 200 patient were classified into the following: A – 100 patients in whom abortion has occurred whether evacuation and curettage (E.&C.) was done or not and B – 100 patients complaining of primary infertility. Results: Hysteroscopy was normal in about 44% of patients group and 45% in control group. Observed abnormalities were septate uterus in 17 cases, intrauterine synechiae in 30 cases, submucus myoma in 10 cases, deformed cavity in 5 cases and endometrial polyp in 35 cases. Endometrial abnormalities (fibrosis, inflammation or atrophy) were observed in 7 patients. No significance was found regarding the total number of intrauterine pathologies when comparing the groups of primary versus secondary infertility. Patients group showed higher prevalence of Intra Uterine Septum and Intra Uterine Adhesions. Control group showed higher prevalence of endometrial polyp, submucous myoma and Endometritis. Other findings showed nearly equal prevalence in the two groups. Conclusion: There is a direct correlation between the number of abortions, number of evacuations (E.&C.) and degree of intra-uterine adhesion, and an increase in the number of abortions is associated with an increase in the degree of intra-uterine adhesions. However, in this study, there was no significant difference between degree of intra-uterine adhesions in the two groups (patient group and control group). Our data are an additional argument to suggest hysteroscopy as part of investigation in infertile woman. Routine diagnostic hysteroscopy should be part of an infertility work-up in primary and secondary infertility.