Contributions of acquired anatomical abnormalities of fallopian tubes in some gynecological disorders in Mosul provinceIraq : a single center study

الملخص EN

Objective: Amenorrhea and infertility are health problems that adversely affect the society, however; for unfortunate reasons; they are underappreciated especially in developing countries.

Several anatomical factors as the tubal factors can lead to hypomenorrhea or amenorrhea, infertility, pregnancy loss, and other obstetric sequels.

Little is known about the contributions and frequencies of the anatomical fallopian tubal factors in such disorders in Nineveh Province/Iraq.

The aim of this study was to determine the frequencies of different fallopian tubes abnormalities in females who presented with infertility and/or amenorrhea in Nineveh province.

Methods: This work was done in Al-Batool Maternity Teaching hospital in the west of Nineveh Province in Northern Iraq.

It included analysis of data which were obtained from the reports of 1682 women who were admitted to Al-Batool Maternity Teaching Hospital as they were referred to the infertility institute either as they are complaining from infertility and or amenorrhea.

All cases that enrolled in the present work had undergone laparoscopy, while laparoscopic examination was done beside hysterosalpingography in women who had history of infertility and amenorrhea.

Results: Data of the present work were grouped according to the complaints of cases into 4 groups: Group 1 includes cases presented with history of primary amenorrhea (n=81).

Normal fallopian tubes were noticed in 51 (62.9%) out of 81 cases, while laparoscopic examination of 30 (37%) out of 81 cases showed different congenital tubal abnormalities.

Group 2 included women who suffer from primary infertility (n=1069).

Normal fallopian tubes were noticed in 714 (66.7%) out of 1069 cases.

Different tubal abnormalities were noticed in 26.8% of 1069 infertile patient, including tubal occlusion in 148 (13.8%) out of 1069 women, hydrosalpinx in 44 (4%) out of 1069 cases.

Features of tuberculosis were detected in 5 (0.4%) out of 1069 women.

Tubal inflammation was shown in 30 (2.8%) out of 1069 cases, while 60 (5.6%) out of 1069 women revealed mixed acquired findings.

Sixty- eight (6.3%) out of cases showed different congenital tubal abnormalities.

Acquired uterine abnormalities were shown in in 123 (11.5%) out of 1069 cases.

Group 3 includes cases presented with history of primary amenorrhea and primary infertility (n=9).

Normal tubes were shown in 1 (11%) out of 9 women, 8 (88.8%) out of 9 women presented with congenital anatomical tubal abnormalities.

Group 4 included 523 women with secondary infertility.

Normal tubes found in 336 (64%) out of 523 women, while 179 (34%) showed different tubal acquired abnormalities.

Different congenital tubal abnormalities were noticed in 8 (1.5%) out of 523 women in this group.

On the other hand, acquired uterine abnormalities were shown in 64 (12%) out of 523 cases.

Conclusions: Acquired tubal factors are the most frequent cause of infertility.

The clinicians should take in considerations the factors that lead to different tubal diseases (especially the infectious one that result in tubal occlusion), and that may help to achieve a decrease in rates of infertility.