Background:

Ultrasound is a commonly used diagnostic tool in the evaluation of female infertility. It can be used to visualize the ovaries, uterus, and fallopian tubes, and can help to identify structural abnormalities or other issues that may be contributing to infertility. It's important to note that ultrasound is not always able to identify the specific cause of infertility, but it can help to identify potential issues that may be contributing to the problem.

Objective: to find the prevalence of reproductive system abnormalities in primary and secondary female infertility.

Methodology:  It was a cross-sectional multicentric study conducted at Gilani Ultrasound center, University Green Town clinic and Jamiat Hospital Lahore in duration of 18 months. 636 (318 fertile and 318 infertile) participants were included by using convenient sampling technique. All married females with age group of 18 – 45 years who had any pelvic abnormality were included. Females on infertility treatment and with pelvic congenital abnormalities were excluded.

Results: Uterine abnormalities are more prevalent in women with primary or secondary infertility compared to those who are fertile. Adenomyosis is found in 63.6% of women with secondary infertility, but only 9.1% of women with primary infertility and 27.3% of fertile women. Similarly, endometrial polyps are found in 72.7% of women with secondary infertility and 27.3% of women with primary infertility. Endometrioma is more common in women with primary infertility (36.7%) compared to women with secondary infertility (28.3%). This difference is statistically significant (p=0.015). Overall, these results suggest that certain ovarian abnormalities may be more prevalent in women with primary infertility compared to those with secondary infertility or normal fertility. Hydrosalpinx is strongly associated with secondary infertility. The p-value (0.000) also indicates that this association is statistically significant. PID is more common in secondary infertility than primary infertility. Pelvic ascites is more common in secondary infertility than primary infertility.

Conclusion: Study concluded that prevalence of secondary infertility was higher than primary infertility. Uterine and ovarian abnormalities are more prevalent in women with primary or secondary infertility compared to those who are fertile. Hydrosalpinx was found to be strongly associated with secondary infertility. PID and pelvic ascites were also more common in women with secondary infertility.

Keywords: Primary infertility, Secondary infertility, Fertility, Pelvic Abnormalities, Uterine.