Evaluation of histopathology of endometrium in primary infertile women, a prospective five years observational study in Konaseema region of Andhra Pradesh


  • Annapurna P. Department of Pathology Konaseema Institute of Medical Science, Amalapuram, Andhra Pradesh, India
  • Niharika Pattnaik Department of Pathology Konaseema Institute of Medical Science, Amalapuram, Andhra Pradesh, India




Primary infertile, Endometrium, Histopathology


Background: Histopathology of endometrium is considered important investigation in case of infertility. The functional disturbance involved in infertility may result in morphological changes in endometrium. Endometrial histopathology is helpful in dating of endometrium so that hormonal status, ovulation and infertility.

Methods: The material for this study consists of endometrial tissue obtained from patients. It was collected either by endometrial biopsy or curettage of uterus done in the minor OT department of obstetrics and gynaecology. The specimen was processed paraffin tissue processing and section of five micrometer was cut and stained with hematoxylin and eosin and ZN staining as per requirement.

Results: Morphological and histopathological pattern of endometrium of patients with primary infertility, anovulatory (proliferative endometrium was present in 24 (30%) patients, simple hyperplasia was present in 16 (20%), deficient secretary phase was present in 26 (32.50%) patients, adequate secretary phase was present in 7 (8.75%) patients. Endometrial tuberculosis was diagnosed in 4 (5%) patients and in one patient neoplastic change was found. Arias Stella reaction was present in 1 (1.25%) patients.

Conclusions: From present study we can conclude that the mean age of patients with primary infertility was 25.76±3.21 years and most of the patients were between 26 to 35 years of age. Regular menstrual cycle was present in 54 (67.5%) patients and 32.5% patients were presented with irregular cycle. The duration of infertility between 3 to 6 years was present in 34 (42.5%) patients. Secretory endometrium was present in 52.5% patients and was most common finding followed by proliferative endometrium. Endometrial tuberculosis was present in 2.5% patients.


Strowitzki T, Germeyer A, Popovici R, von Wolff M. The human endometrium as a fertility-determining factor. Hum Reprod Update. 2006;12(5):617-30.

Infertility. Available at: https://www.who.int/news-room/fact-sheets/detail/infertility. Accessed on 20 September 2021.

Infertility. Available at: https://www.nhp.gov.in/ disease/reproductive-system/infertility. Accessed on 20 September 2021.

Sabharwal BD, Sofat R, Chander K. Endometrial pattern and its glycogen content in case of infertility. J Obstet Gynaecol India. 1987;37:718-21.

Balasch J, Fábregues F, Creus M, Vanrell JA. The usefulness of endometrial biopsy for luteal phase evaluation in infertility. Hum Reprod. 1992;7(7):973-7.

Zawar MP, Deshpande NM, Gadgil PA, Mahanta AA. Histopathological study of endometrium in infertility. Indian J Pathol Microbiol. 2003;46(4):630-3.

Sahmay S, Oral E, Saridogan E, Senturk L, Atasu T. Endometrial biopsy findings in infertility: analysis of 12,949 cases. Int J Fertil Menopausal Stud. 1995; 40(6): 316-21.

Sample size for a prevalence survey, with finite population correction. Available at: http://sampsize. sourceforge.net/iface/. Accessed on 20 September 2021.

Purkayastha P, Sharma H. Prevalence and potential determinants of primary infertility in India: Evidence from Indian demographic health survey. Clin Epidemiol Global Health. 2021;9:162-70.

Dallenbalch-Hellweg G. The endometrium of infertility, A review. Pathol Res Pract. 1984;178:527-37.

Preethi C, Soumya B, Gupta H, Nilekani A, Rajashekar K. A histomorphological pattern analysis in endometrial biopsies of infertile woman. IP Arch Cytol Histopathol Res. 2019;4(3):187-92

Adamson PC, Krupp K, Freeman AH, Klausner JD, Reingold AL, Madhivanan P. Prevalence & correlates of primary infertility among young women in Mysore, India. Indian J Med Res. 2011;134(4):440-6.

Katole A, Saoji AV. Prevalence of primary infertility and its associated risk factors in urban population of central india: a community-based cross-sectional study. Indian J Commun Med. 2019;44(4):337-341.

Sasaki RS, Approbato MS, Maia MC, Fleury EA, Giviziez CR, Zanluchi N. Patients' auto report of regularity of their menstrual cycles. Medical history is very reliable to predict ovulation. A cross-sectional study. JBRA Assist Reprod. 2016;20(3):118-22.

Arnhold IJ, Latronico AC, Batista MC, Mendonca BB. Menstrual disorders and infertility caused by inactivating mutations of the luteinizing hormone receptor gene. Fertil Steril. 1999;71(4):597-601.

Zyklusanomalien TG. Menstrual cycle anomalies in young girls--prognosis concerning later fertility. Gynakol Geburtshilfliche Rundsch. 1998;38(1):47-9.

Elhussein OG, Ahmed MA, Suliman SO, Yahya LI, Adam I. Epidemiology of infertility and characteristics of infertile couples requesting assisted reproduction in a low-resource setting in Africa, Sudan. Fertil Res Pract. 2019;5:7.

Zhou Z. Epidemiology of infertility in China: a population-based study. BJOG. 2018;125:432-41.

Nandedkar SS, Patidar E, Gada DB, Malukani K, Munjal K, Varma A. Histomorphological Patterns of Endometrium in Infertility. J Obstet Gynaecol India. 2015;65(5):328-34.

Ahmed Ma, Afroze NB, Sabiha M. Histopathological study of endometrium in infertility: experience in a tertiary level hospital. Birdem Med J. 2012;8(2):45-9.

Shaheen R, Subhan F, Tahir F. Epidemiology of genital tuberculosis in infertile population. J Pak Med Assoc. 2006;56(7):306-9.






Original Research Articles