Frequency of Congenital Anatomical Uterine Abnormalities in a Group of Infertile Women in Mosul city

Ibrahim Khalel Al-Allaf, Luma

	Frequency of Congenital Anatomical Uterine Abnormalities in a Group of Infertile Women in Mosul city
IRAQI JOURNALOF COMMUNITY MEDICINE
Article 1, Volume 22, Issue 4, 2009, Pages 238-246
Author
Luma Ibrahim Khalel Al-Allaf
Abstract
Background: Congenital Müllerian defects are a fascinating clinical problem encountered by obstetricians and from a therapeutic point of view, it is interesting to know the prevalence of the different types of uterine anomalies. The incidence of the anatomical uterine anomalies in the infertile women population was found to range between 1-26.2 %; however the exact incidence of congenital uterine anomalies in women with reproductive failure remains unclear, largely due to methodological bias. Objectives: The aims of this study are to estimate the incidence of congenital uterine anomalies in women with infertility, to determine the frequencies of different subtypes of these anomalies in infertile women and to compare the contribution of these anomalies with acquired one. Setting: Infertility unit in Al-Batool Maternity Teaching Hospital/ in Mosul city in Northern Iraq. Methods: This was a retrospective study that was conducted over a period of 4 months started from 1st January 2008 to April 30th 2008.The data were collected from the medical reports of women referred to the infertility unit over the period of 1998-2008 for infertility problems. All of them had undergone laparoscopic assessment beside hysterosalpingography. They were classified into 3 groups: Group 1: included women who were presented with primary infertility (n=1070), group 2: included 512 women presented with secondary infertility, and. group 3: which included 10 women, presented with primary infertility and primary amenorrhea. The uterine malformations were grouped in accordance with the American Fertility Society classification (AFS). Results: Ninety one (5.68%) out of 1601 infertile women had got congenital anatomical uterine anomalies. According to AFS classification uterine agenesis /dysgenesis was reported in 54(3.37%) out of 1601 infertile women, while septate uterus identified in 13 (0.81%) out of 1601 infertile women .On the other hand the laparoscopic reports of 12 (0.74%) out of 1601 infertile women revealed the presence of bicornuate uterus, while unicornuate type was identified in 3 (0.18%) out of 1601 infertile women. Four (0.24%) out of 1601 infertile women had got didelphic uterus, while more than one class was revealed in the reports of 5(0.31%) out of 1601 infertile women. Agenesis /dysgenesis represent highest frequency among Müllerian anomalies in infertile women in 54 out of 91(57.95%), while septate class was being the second to the Agenesis /dysgenesis and was shown in 13out of 91(14.77%) women. The ratio of septate /bicornuate uterus in this study was 1:1.On the other hand, 176(10.99%) out of 1601 infertile women had got acquired anatomical uterine anomalies. Conclusion: The overall incidence of congenital anatomical uterine anomalies in infertile women attending the infertility unit in Mosul city was 5.68%. Highest frequency among Müllerian anomalies in infertile women was in Agenesis /dysgenesis; while septate class was the second frequent one. The frequencies of acquired anatomical (uterine and tubal) anomalies were significantly higher than that of congenital anomalies (P<0.05%).Further studies will be recommended to define the actual incidence of uterine anomalies in fertile and infertile women beside the determination of reproductive performance of these anomalies. Keywords: Infertility, congenital uterine anomalies, Müllerian anomalies.
Keywords
infertility; congenital uterine anomalies; llerian anomalies

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