Histological analysis of endometrial curettings performed for infertility in Nigeria

Over a 10-year period (January 1985 - December 1994) 1060 consecutive infertile patients had endometrial biopsy as part of the infertility evaluation protocol. Four hundred and six patients (38.3%) had primary infertility while 654 (61.7%) had secondary infertility. The mean age was 31.7 years. The histology results of the endometrial currettings were as follows: secretory endometrium (56.7%), endometrial hypoplasia (20%), proliferative endometrium (16.6%), pregnancy (5%) and non-specific endometritis (1.7%). Secretory endometrium was the most frequent histological finding. The employment of dilatation and curettage can inadvertently disrupt an ongoing early pregnancy, as seen from the study. In conclusion, lack of infrastructure and investigatory facilities due to poor funding makes comprehensive infertility management impossible in developing countries. In such countries, centres of excellence for infertility management should be designated together with the provision of an enabling environment for private-sector involvement.