Sonographic Association of Nabothian Cyst on Transvaginal Scan In Female with Primary and Secondary Infertility Annum Majeed1, Raham Bacha1, Syeda Khadija tul Sughra Murrium1, Syed Muhammad Yousaf Farooq11, Amjad Iqbal3, Abdur-Rehman Tuaha Mansoor1, Mahjabeen Liaqat1, Saba Majeed1, Rabia Majeed2 1Afro Asian Institute, Lower Mall, Lahore. 2Minhaj University, Lahore. 3Diagnostic Ultrasound Thomas Jefferson, USA. *[email protected] Abstract: correlation between number and size of Infertility is very common social, economic and Nabothian cyst with infertility. medical problem. There are various causes of Key words: infertility, Nabothian cysts plays a vital role. Primary Infertility, Secondary infertility, Objective: Nabothian cysts, Ultrasound. To evaluate Sonographic association of Introduction: Nabothian cyst on Transvaginal scan in Female Infertility is a global health problem which is with primary and secondary infertility predominantly affecting the developing Methodology: countries. Infertility is now recognized by the This Cross-sectional analytical study was World Health Organization as a reproductive conducted at Jamiat Hospital. Study duration system condition. It can be primary or was 9 months. Sample size was 156 patients. secondary. The inability to achieve a rst Sampling technique was convenient sampling. pregnancy is known as primary infertility, while All Infertile Females with Nabothian cysts, age of the inability to achieve a second pregnancy is 1,2 18-45 were included in study. Females with known as secondary infertility . The prevalence polycystic ovarian syndrome and genital varies on the basis of geography and anomalies were excluded. Ultrasound machine development, as well as the gender. Considering Namio 35, Transvaginal High Frequency Probe 5 women infertility, countries like Norway, -7.5 MHz was used. Poland, Romania, Czech Republic and Ukraine, Results: prevalence has been recorded between 5-8% and The sample size was 155 patients, 100% marital in Sweden and Canada, it has been recorded up 3 status of married female with 82% primary to 10% . In the 2002 National Survey of Family infertility and 36.1% secondary infertility. 89%| Growth, an estimated 7.4 million women, or 12 participant lies in infertility and 11% has no percent of the female population of reproductive infertility. Mean age was 29.21 ± 4.616 S.D. The age in the United States, were reported to be minimum age of patients was 20 and Maximum infertile. Pakistan experiences a massive age 41. Out of 155 patients Nabothian cyst was prevalence rate of 21.9%, primary infertility is 2 present ; 1 in (29.7%), 2 in (43.2%), 3nin (18.1%), 4 3.9% while secondary infertility is 18%. in (7.7%) and 5 in(1.3%). Vintage of marriage 1.50 Infertility is a devastating disease which affects years (3.2%), 2 (24.5%), 2.50 (1.9%), 3 (27.7%), its victims at a very basic level. It is not a life- 3.50(1.9%), 4(5.8%), 5(15.5%), 6 (6.5%), 7(5.2%), threatening condition, it is, however, a life course 4 8(3.2%), 9 (1.3%), 10(1.3%) and 12(1.9%). crisis with unintended consequences and losses . Nabothian cysts are typical lesions of the uterine Conclusion: 5 The study concluded that there is signicant cervix. Nabothian cysts are retention cysts . They AJAHS VOL. 06 ISSUE 02 APRIL-JUNE 2021 38 Sonographic Association of Nabothian Cyst on Transvaginal Scan are also commonly found in menopausal women the patient in details and consent form was whose cervix has thinned with age. Less signed from the patient. Patient privacy was frequently, they are associated with chronic kept. Transducer was inserted through vagina if cervicitis6. Nabothian cysts are usually located in possible the patient was allow to insert the the endocervical gland7. These cysts are most transducer through vagina. Prepare the often found in the submucosal layer of the cervix, transducer before start the exam. Put the gel on but they can also be found deep inside the the top of transducer and cover it with condom. cervical wall 8. They are generally multiple, The exam was consist on size shape and position translucent or opaque, and whitish to yellow and of the uterus, cervix and vagina. Right and left are a few millimeters to 3–4 cm in diameter9,10. adnexa was also evaluated. Data was collected in Such large cysts may be the cause of prolonged the form of collection sheets for all the variables irregular menstrual bleeding8, chronic pelvic including: age, occupation, previous history, pain6,8 fullness feeling in the vagina10 and watery symptoms, number of Nabothian cysts, size on discharge11. When large enough, they may transvaginal scanning, infertility, and protrude out of the vagina or may cause primary/secondary. Data was tabulated and prolapsing of pelvic organs12.13. Transvaginal analyzed with the help of SPSS version 21.The scanning are most effective in evaluation of Data was reported using descriptive statistics. pelvic disorders related to pelvic infertility14. In Results: Transvaginal scanning and transabdominal This chapter was consisted on statistical results, scanning, Nabothian cysts present themselves as their explanation, graphs, tables and frequencies 15 anechoic cystic structures . In the assessment of of the factors involved in this study. The sample endometrial pathology, transvaginal scanning size was 155 patients in table 1 shown 100% sensitivity and specicity are approximately marital status of married female in gure 1. Table 100% and 92.9 percent, respectively, while number 2 shown 82% primary infertility and transabdominal scanning sensitivity and 36.1% secondary infertility gure number 2. specicity are 92.8 percent and 65 percent, Table number 3 shown infertility 89%| 16 respectively . The early diagnosis and timely participant lies in infertility and 11% has no management of nabothian cysts can reduce infertility with gure number 3. Mean age was female infertility to some extent. This way the 29.21 ± 4.616 in 5 number of gure. The minimum quality of life could be improved to overcome age of patients were 20 and Maximum age 41 in this social, economic and medical problem. table 5, gure 5. According to table number 6 out Methodology: of 155 patients number of Nabothian cysts in 1 This Cross-sectional analytical study was (29.7%), 2(43.2%), 3(18.1%), 4(7.7%) and 5(1.3%). conducted at Jamiat Hospital, Lahore . Study Table number 7, gure number 7 shown duration was 9 months. Sample size was 156 duration of marriage in 1.50 years (3.2%), 2 patients. Sampling technique used was (24.5%), 2.50 (1.9%), 3 (27.7%), 3.50(1.9%), convenient sampling. All Infertile Females with 4(5.8%), 5(15.5%), 6 (6.5%), 7(5.2%), 8(3.2%), 9 Nabothian cyst, age of 18-45 were included in (1.3%), 10(1.3%) and 12(1.9%). Total 155 patients study. Females with polycystic ovarian out of 0.00 parity 16.1%, 1 parity 51.0%, 2 parity syndrome and genital anomalies were excluded. 32.3% and 3 parity 0.6 shown in table number 8 Ultrasound machine Namio 35, Transvaginal and gure number 8. Whereas table number High Frequency Probe 5 -7.5 MHz was used. For 9,10,11 and 12 shown cross tabulation with Transvaginal ultrasound the urinary bladder relation of number of Nabothian cysts, age was empty with lithotomy position vaginal canal related infertility and type of infertility, parity was free from tampons. Explain the procedure to and infertility. AJAHS VOL. 06 ISSUE 02 APRIL-JUNE 2021 39 Sonographic Association of Nabothian Cyst on Transvaginal Scan No. of Type of Infertility unknown but in advanced age to diagnose or Nabothian Cysts Seco- Chi- nding the lesion that helped to improve the Primary No ndary Total square 18 test infertility . While logically unsuitable nding to Count 13 14 19 46 manage the reasonable point. Lack of powerful 1.00 % within Number 28.3 mediation condition like endometriosis, minor 30.4% 41.3% 100% of Nabothian Cysts % degree of tubal lesion, immunological causes Count 4 36 27 67 and poor ovarian cannot improved the results. 2.00 % within Number 6% 53.7% 40.3 100% The term “unexplained” indicates the infertility. of Nabothian Cysts Cervical polyps, cervix erosion, and condyloma Count 0 22 6 28 3.00 are benign uterine cervical lesions. Nabothian % within Number 0.0% 78.6% 21.4% 100% of Nabothian Cysts cysts, on the other hand, are usually symptom- .000 free because they are small, measuring diameter Count 0 8 4 12 4.00 in millimetres. Nabothian cysts can grow up to 4 % within Number 19 of Nabothian Cysts 0.0% 66.7% 33.3% 100% centimeter in diameter can be dangerous . Count 0 2 0 0 Nabothian cysts in the uterine cervix, up to 8 cm 5.00 % within Number in diameter, can cause many symptoms and can of Nabothian Cysts 0.0% 100% 0.0% 100% even be mistaken for tumors or malignancy 20. Count 17 82 56 155 Other studies nding the infertility by using an Total % within Number 11.0 ultrasound machine. Infertility is a medical issue 52.9% 36.1% 100% of Nabothian Cysts % that requires a suitable therapy system. Recent 20 Table 1: Cross Tabulation number of nabothian years medical science created a progressed to cyst tith type of Infertility help the treatments. Major facts of female infertility is poly cystic ovary syndrome, Fundal Mean N Std. Deviation broid, PID, endometria, menstrual issues the Fertile 3.9059 17 1.11101 most danger factor that cause infertility The Infertile 7.3304 138 3.79892 kordfan ministry health state to helping and Total 6.9548 155 3.75759 resolving the issues in population. The clinical Table 2: Size of nabothian cysts in fertile and and nancial help of infertile women which infertile females i m p l i e s t o a d m i t t a n c e t h e c l i n i c a l Table 2 shows that polycystic ovarian syndrome administrations, higher protection inclusion, effects endometrial thickness more as compare wide social help, and data are signicant 21 to other abnormalities.