Hindu Ibrahim Hussein, Sanun Ally Kessy, Alfred Deo Luvakule, Bahati Simon Katembo, Shemsa Said Khatib, Alphonce Chandika, Monica S Kessy, Abel N Makubi
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引用次数: 0
Abstract
Background: Infertility affects an estimated 48 million couples globally, with disproportionately high rates in sub-Saharan Africa. Intrauterine abnormalities are common but underdiagnosed causes of infertility, particularly in low-resource settings where advanced diagnostic tools such as hysteroscopy are underutilized. This study aimed to compare hysteroscopic findings between women with primary infertility and those with secondary infertility at Benjamin Mkapa Hospital, Tanzania.
Methods: A hospital-based cross-sectional study was conducted among women with infertility who underwent diagnostic hysteroscopy. Simple random sampling was used. Hysteroscopic findings were categorized via the European Society for Gynecological Endoscopy (ESGE) classification system. The data were analyzed via Stata version 18.
Results: A total of 198 women with infertility 103 (52.02%) with primary infertility and 95 (47.98%) with secondary infertility were included. Abnormal hysteroscopic findings were more prevalent in women with secondary infertility 56 (58.95%) than in those with primary infertility 28 (27.18%). The number of intrauterine adhesions was notably greater in the secondary infertility group (13.7%) than in the primary infertility group 6 (5.8%), with more severe adhesions observed. Conversely, secondary infertility was observed more often in patients with endometrial polyps (11.6%) than primary infertility was.
Conclusion: Secondary infertility is associated to acquired intrauterine pathology, particularly adhesions, which are likely to result from infections or trauma. Routine diagnostic hysteroscopy should be integrated into infertility workups to increase diagnostic accuracy and guide appropriate treatment, especially in resource-limited settings.
背景：不孕症影响着全球约4800万对夫妇，其中撒哈拉以南非洲地区的比例高得不成比例。宫内异常是常见的不孕症原因，但未得到充分诊断，特别是在资源匮乏的地区，宫腔镜等先进诊断工具未得到充分利用。本研究旨在比较坦桑尼亚Benjamin Mkapa医院原发性不孕症和继发性不孕症妇女的宫腔镜检查结果。方法：一项以医院为基础的横断面研究对接受诊断性宫腔镜检查的不孕妇女进行了研究。采用简单随机抽样。宫腔镜检查结果通过欧洲妇科内镜学会（ESGE）分类系统进行分类。数据通过Stata version 18进行分析。结果：不孕症198例，原发不孕症103例（52.02%），继发不孕症95例（47.98%）。继发性不孕症患者宫腔镜异常发生率56（58.95%）高于原发性不孕症患者28（27.18%）。继发性不孕症组宫腔粘连发生率（13.7%）明显高于原发性不孕症组（5.8%），且粘连更为严重。相反，继发性不孕在子宫内膜息肉患者中更为常见（11.6%）。结论：继发性不孕症与获得性宫内病理有关，特别是粘连，这可能是由感染或创伤引起的。常规诊断宫腔镜应纳入不孕症检查，以提高诊断准确性和指导适当的治疗，特别是在资源有限的情况下。
期刊介绍：
BMC Women''s Health is an open access, peer-reviewed journal that considers articles on all aspects of the health and wellbeing of adolescent girls and women, with a particular focus on the physical, mental, and emotional health of women in developed and developing nations. The journal welcomes submissions on women''s public health issues, health behaviours, breast cancer, gynecological diseases, mental health and health promotion.
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