The Endometrium Biopsy and Hystero-Laparoscopy in Evaluation of Women’s Infertility. A Prospective Study in Algeria

Abstract

Female infertility is considered as a real obstacle to the development of a couple who cannot conceive in a natural way. The aim of this study is to evaluate female infertility using two complementary methods of exploration: hystero-laparoscopy and endometrial biopsy, to compare histopathological data with those of hystero-laparoscopy findings in the same patients, and finally assess the interest to couple both methods to detect a greater number of pathologies. Our prospective study included 64 patients aged 20 -43 years with primary or secondary infertility for a period of 3 years ranging from 2012 to 2015 at obstetrics and gynecology department in which all patients were admitted to a hysteroscopy followed by laparoscopy. Endometrial biopsy curettage was performed and sent to the Pathological Anatomy Department for a histopathological study. On 64 infertile women explored, no pathologies were findings in 20 patients (31.3%) to the biopsy and 27 patients (42.2%) by hysteroscopy-laparoscopy. Histopathological study was in favor of dysfunctional endometrium (50%) followed by hyperplasia (10.9%). The lesions findings in the hystero-laparoscopy were in the first place uterine (18.8%) followed by equally between tubal and endometrial pathologies (10.9%). Associated diseases affecting the same organs or more were recorded with a percentage of 7.8%. The two methods have been shown effective and the most of common pathologies findings were uterine and endometrial. We concluded that the endometrial biopsy was more decisive in the exploration of endometrium pathologies while hystero-laparos-* Corresponding author. N. Cheheb et al. 211copy is more sensitive for the exploration of uterine, tubal and ovarian pathologies. Each method taken individually was revealed incomplete. It is more interesting to systematically couple the histology with endoscopic examination in order to detect a greater number of pathologies.

A study on glycogen content of endometrial glands in infertile women

“…58 cases out of 75 cases (77.3%) studied. Similar findings have been documented by Kauret al 7 (77.14%) and Chelab et al 8 (71.90 %).…”

“…In spite of biopsies sampled in the premenstrual phase, proliferative /anovulatory pattern was the most common cause of infertility. Similar findings were also observed by Girishet al 4 from Shimoga and Ikeme et al 11 in Nigeria and Cheleb et al 8 in Algeria. Other studies have found a secretory pattern to be more common which is an expected finding in a premenstrual biopsy.…”

Histopathological Study of Endometrium in Infertility: Experience in A Tertiary Level Hospital

“…Similar findings were also observed by Girish et al , 14 in India and Ikene et al in Nigeria 10 and Cheleb et al in Algeria. 9 However, other studies conducted in India and Pakistan, found secretory phase was the most common cause of infertility followed by proliferative phase. 8,11,15 Among the secretory phase we found late secretory phase was most frequent (25% cases).…”

“…Similar findings were also observed in the studies conducted by Kaur et al 8 in India and Chelab et al in Algeria. 9 Where they found women presented with primary infertility in 77.14% and 71.90 % cases respectively. Whereas, in Nigeria secondary infertility (61.7%) occurred more than primary infertility (38.3%).…”

“…Mean age was 33 years and age ranged from 23-43 years. 9 The reason may be that overall women literacy and employment rate is higher in Algeria. 12,13 In our study, we found that proliferative phase/ anovulation was the most common cause of infertility followed by secretory phase.…”