Categorisation of Adnexal Masses in Infertile Women: A Retrospective Cohort Analysis

Objectives Adnexal lesions are often detected incidentally during infertility evaluation. However, limited data exists on the pathological profile of adnexal lesions detected, particularly in infertile women. In this study, we aim to assess the histopathological profile of adnexal masses in infertile women. Material and Methods Retrospective analysis of infertile women with an adnexal mass undergoing surgery between 1 January 2018 and 30 May 2024 was done. Details pertaining to demographic profile, ultrasonography, biochemical markers, surgical findings and histopathology were retrieved. Histopathological profile was studied as per the Royal College of Obstetricians and Gynaecology (RCOG) histopathological classification. Statistical analysis was done using the SPSS Statistics software (v27.0). Results Of the 5170 patients screened, 62 patients eligible for study criteria were included. The mean age (standard deviation [SD]) was 33.1 (4.6) years, with 85.5% (53/62) of patients being nulliparous. Ultrasonographic evaluation revealed bilateral adnexal lesions in 25.8% (16/62) patients. Most patients underwent laparoscopic surgery (91.9%, 57/62). CA-125 was available for 34 patients and was raised in 58.9% (20/34) patients. The histopathological profile revealed 93.6% (58/62) of patients having benign lesions of ovarian origin, while 3.2% (2/62) had benign lesions of non-ovarian origin. Endometriosis (66.1%, 41/62) and mature teratoma (12.9%, 8/62) were the most common benign lesions. Two patients (3.2%) with malignancy had borderline mucinous tumours. Conclusion Benign ovarian lesions form the most common adnexal masses in women of reproductive age group who present with infertility; however, malignancy is not uncommon. Endometriosis and mature teratoma appeared to be the most common benign lesions.