FREQUENCY OF BILATERAL TUBAL OBSTRUCTION AND COMMON FACTORS LEADING TO IT AMONG WOMEN PRSESENTING WITH SECONDARY INFERTILITY

Abstract

BACKGROUND: Infertility is not uncommon in our female population as we live in a geographical
area where the population growth rates are amongst the highest in the world. A variety of cultural norms
and values force couples to enhance family. So a sensitive and dedicated efforts need to be made to look
into the causes of secondary infertility and their treatment.
OBJECTIVES: To determine the frequency of bilateral tubal obstruction and common factors leading
to it among women presenting with secondary infertility.
METHODOLOGY: It was a hospital based descriptive cross sectional study conducted at the
department of obstetrics & gynecology Postgraduate medical institute LRH Peshawar from 8th August
2011 to 8th July 2013. Data was collected by non probability consecutive sampling technique. A total of
260 patients were enrolled in study. In patients presenting with secondary infertility
hysterosalphingography was performed, in those with bilateral tubal obstruction detailed history was
taken to detect, the history of instrumentation to genital tract, lower abdominal surgery or history of
PID. Laparoscopy was done in all patients with bilateral tube obstruction to confirm the diagnosis and
determine causes.
RESULTS: In this study mean age was 30 with standard deviation of ±2.12. Bilateral tubal obstruction
was found in 73(28%) of the cases, out of which history of pelvic inflammatory disease was present
in15 (21%) followed by history of instrumentation of genital tract in 11(15%) of cases. Positive history
of lower abdominal surgery was present in 4(5%) and 3(4%) patients had fibroids.
CONCLUSION: Tubal pathology is one of the main causes of female infertility. A great caution is
required in pelvic operative techniques to prevent infection and tubal damage.
KEY WORDS: secondary infertility, bilateral tubal obstruction, pelvic inflammatory disease.