Endometrial biopsy in women with primary infertility

Of 2616 endometrial biopsies received over a 55 month period, 1022 (39.1%) were from patients with primary infertility. All endometria from these patients were reviewed and while most diagnosis agreed with the primary diagnosis made by the reporting pathologist, an interobserver difference of 6.8 per cent was found. This difference occurred only on biopsies with anovulatory endometrium. Of the 1022 patients, 238 had definite hormonal derangements as assessed by morphological means on endometrial biopsy. Anovulation as assessed by glandular stromal dissociation and as a cause of infertility was noted in 12.6 per cent patients. The incidence of anovulation increased over the age period of 20-25 yr, with a peak at 25 yr. A close parallel was found of the period of anovulation and the period of nubility. An inflammatory cause for the infertility appeared to be negligible in our series.