ANALYTICAL STUDY OF CAUSES OF INFERTILITY IN COUPLES ATTENDING TERTIARY CARE CENTRE OF RURAL BIHAR

2021 ◽  
pp. 81-83
Author(s):  
Rashmi Verma
Keyword(s):  
Tertiary Care ◽  
Semen Parameters ◽  
Polycystic Ovaries ◽  
Male Factor ◽  
Unprotected Sexual Intercourse ◽  
Male And Female ◽  
Primary Infertility ◽  
Ovulatory Dysfunction ◽  
Uterine Anomalies ◽  
High Level

Background:Infertility is a life crisis affecting patients from all around the world. It is a disease of the reproductive system dened by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Worldwide, its prevalence is approximately 8-12%. Aim:To determine the causes and clinical pattern of infertility in couples based on clinical and laboratory nding Methods: It was hospital based observational study carried out in the department of Obstetrics and Gynaecology of Katihar Medical College and Hospital, from Feb 2019 to Jan 2020. 300 women were selected for the study with the diagnosis of infertility and 36 of them were lost to follow up so 264 women were enrolled in the study Result: Out of 300 women, 264 had all the data and they participated in the study. Maximum women (50%) were in age group 20-29 yrs. The median duration of marriage was 5 yrs. Primary infertility was in 70% women and 30% women presented with secondary infertility. Female factor was found in 48.1% cases, 15.2% cases had only male factor, 28% having both male and female factor whereas 8.7% cases were with unexplained infertility. Features of polycystic ovaries and ovulatory dysfunction were found in 14.4% women. Adnexal pathology was seen in 10% cases, uterine broid detected in 10.6% cases and uterine anomalies were found in 1.5% cases. High level of TSH (TSH≥4) were found in 32 (12.1%) women and 14 women (5.3%) diagnosed with hyperprolactinemia (≥25ng/ml). Approx. 3.4% women were found to have high level of FSH≥10, whereas LH was raised in 2.3% cases. 14.4% male had abnormal semen parameters. Common abnormalities were azoospermia 6% and oligozoospermia in 3.8% and asthenospermia in 4.5% cases. Conclusion: Primary infertility cases are more common with female factor predominance over male factor. Ovulatory dysfunction, tubal pathology, hormonal imbalance and abnormal semen parameters were main contributing factor for infertility. Male and female both factors are responsible for infertility. So, both partners should be counselled and investigated properly.

scholarly journals Evaluation of cases of infertility by diagnostic laparoscopy

2017 ◽  
Vol 6 (3) ◽  
pp. 924
Author(s):  
Sachin Wankhede ◽  
Sarika Thakare ◽  
Nivedita Goverdhan ◽  
Santosh Shahane
Keyword(s):  
Diagnostic Laparoscopy ◽  
Male Factor Infertility ◽  
Polycystic Ovaries ◽  
Male Factor ◽  
Secondary Infertility ◽  
Primary Infertility ◽  
Therapeutic Benefits ◽  
Obstetrics And Gynaecology ◽  
Uterine Anomalies ◽  
Tubal Disease

Background: Infertility affects nearly 10-15% of couples and is an important part of clinical practice. Leading causes of infertility include tubal disease, ovulatory disorders, uterine or cervical factors, endometriosis and male factor infertility. The objective of the study was to find out different causes of female infertility with diagnostic laparoscopy.Methods: This was a descriptive study conducted from February 2012 to November 2013. 115 patients with infertility attending the infertility clinic in OPD of Obstetrics and Gynaecology were evaluated clinically with detailed history. The necessary investigations were carried out and the laparoscopic findings were documented.Results: There were 91 cases (79.13%) with primary infertility and 24 (20.87%) with secondary infertility. Laparoscopy revealed normal findings in 14 cases (15.38%) of primary infertility and 1 case (4.17%) of secondary infertility. Pelvic abnormality was found in 100 cases (86.95%). Tubal block was the most common pathology found in 36 cases (31.30%) followed by polycystic ovaries in 32 (27.83%) and adhesions in 24 (20.87%). Uterine anomalies were found in 3 cases (3.30%).Conclusions: Diagnostic laparoscopy is a valuable technique and a mandatory investigation, which, though invasive, is more convenient and more precise for the diagnosis of infertility. Because of its potential diagnostic as well as therapeutic benefits, all patients with infertility should undergo diagnostic laparoscopy as part of their primary workup of infertility.

scholarly journals Analysis of causes and clinical pattern of infertility in couples coming to a tertiary care centre in Bihar, India

2017 ◽  
Vol 6 (6) ◽  
pp. 2279
Author(s):  
Kalpana Singh ◽  
Rekha Kumari ◽  
Alok Ranjan ◽  
Geetam Bharti
Keyword(s):  
Laboratory Tests ◽  
Semen Analysis ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Tertiary Care Centre ◽  
Male Factor ◽  
Secondary Infertility ◽  
Unprotected Sexual Intercourse ◽  
Clinical Pattern ◽  
High Level

Background: Infertility is one of the major health problems and a socially destabilizing condition for couples often causing marital disharmony. Infertility is defined as the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Worldwide, its prevalence is approximately 8-12%.There are numerous factors such as anatomical, physiological and genetic factors that cause infertility. Many environmental and acquired factors also lead to inability to conceive. Objective of the present study was to determine the causes and clinical pattern of infertility in infertile couples.Methods: It was a hospital based observational study carried out on 750 women in reproductive age group attending out-patient clinic of Reproductive Biology Department of Indira Gandhi Institute of Medical Sciences (IGIMS) at Patna during April 2013 to March 2017. All the cases of primary and secondary infertility diagnosed after full examinations and laboratory tests were included and cases lacking of full examinations and laboratory tests were excluded. All the data of infertile couples were recorded in a semi-structured Case Information Performa.Results: Out of 750 women 454 women had all the data and they participated in the study Nearly 68% women had primary infertility and rest had secondary infertility. Male factor was responsible in 37.39%, female factor in 20.48%, unexplained in 22.46% while a combination of both factor was seen in 8.37% cases in our study .135 women had irregular menstrual cycles in which 64(47%) had oligomenohhrea. 79% women had normal ultrasonography and nearly 11% of women had evidence of PCOD. 24% women had hypothyroidism (TSH more than 4.5 IU/L) and 59(13%) were found to have high level of prolactin i.e. >25 ng/ml. Nearly 8% of women had high level of FSH i.e. more than 10 IU/L which is an indicator of ovarian resistance. In nearly 16% women one fallopian tube was found blocked and 8% had both tubes blocked in hysterosalpingography. Husband semen analysis was done to assess male factor. Nearly 14% of their male partners suffered from azoospermia and 23% had at least one abnormal parameter in semen analysis.Conclusions: Etiological pattern of infertility varies in different parts of World. Male and female factors both are responsible for infertility. So, both the partners should be counselled and investigated properly.

scholarly journals Role of diagnostic hysterolaparoscopy in the evaluation of female infertility

2019 ◽  
Vol 7 (5) ◽  
pp. 1531
Author(s):  
Madhuri N. ◽  
Rashmi H. S. ◽  
Sujatha M. S. ◽  
Dhanyata G.
Keyword(s):  
Tertiary Care ◽  
Female Infertility ◽  
Reproductive Age ◽  
Common Finding ◽  
Care Hospital ◽  
Male Factor ◽  
Secondary Infertility ◽  
Unprotected Sexual Intercourse ◽  
Primary Infertility

Background: Infertility is defined by WHO as a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. The prevalence of infertility is about 10%-15% of reproductive age couples. Female factor is responsible for 40-45% of etiology of infertility. Aim of the study was to evaluate the role of diagnostic hysterolaparoscopy in female infertility at a tertiary care centre.Methods: This is a retrospective hospital based study done at a tertiary care hospital attached to JSS Medical College, Mysuru between January 2017 and December 2018. Infertile women with primary or secondary infertility in the 18-40 years age group, with normal hormonal profile and no known male factor were included.Results: In our study, primary infertility was found in 77% of the 96 patients and secondary infertility was found in 23% of patients. In primary infertility, ovarian pathology was the most common finding while Endometriosis was the most common finding in secondary infertility group. 77 % patients were found to have bilaterally patent tubes while remaining had unilateral or bilateral blockage. On hysteroscopy, endometrial polyps were the commonest hysteroscopic finding in both groups.Conclusions: Combined hystero-laparoscopy is a safe, effective and reliable method in comprehensive evaluation of infertility. It helps in the diagnosis of pelvic pathology which may have been missed by routine examination and thereby helps in optimal management of female infertility.

scholarly journals Abnormal semen parameters among males in infertile couples: a cross sectional study from a tertiary care centre

2020 ◽  
Vol 9 (8) ◽  
pp. 3398
Author(s):  
Jyoti Garg ◽  
Rachana Meena ◽  
Shailaja Shukla ◽  
Sunita Sharma ◽  
Riva Choudhury
Keyword(s):  
Semen Quality ◽  
Semen Analysis ◽  
Tertiary Care ◽  
Sperm Concentration ◽  
Semen Parameters ◽  
Medical Attention ◽  
Male Factor Infertility ◽  
Male Factor ◽  
Cross Sectional ◽  
Infertile Couples

Background: In India, the prevalence of primary infertility ranges from 3.9% to 16.8%. Male factor contributes 40-50% of this. Male factor infertility is indicated by decreased sperm concentration, reduced motility, vitality or abnormal sperm morphology. Semen analysis is the single most important investigation to detect male factor infertility. The aim of this study was to analyse the prevalence of abnormal semen parameters among males in infertile couples and their association with contributing factors.Methods: This cross-sectional hospital-based study was carried out in the Department of Pathology at Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital. A total of 400 cases were analyzed during a period of 6 months. Detailed history of the couple was taken. Semen analysis was done using automated semen analyzer (SQA-vision) after 3 days of abstinence according to the WHO 5th edition 2010 guidelines. The results were analysed using excel sheet and SPSS software.Results: In the present study, 122 cases (30.5%) out of 400 cases had abnormal semen parameters. Most common abnormality detected was asthenozoospermia (14.3%) followed by oligozoospermia (13.8%), azoospermia (10.5%) and teratozoospermia (10.5%). There was significant association of alcohol intake, obesity and trauma with abnormal semen parameters.Conclusions: Asthenozoospermia was the most common abnormality noted in this study. Lifestyle modifications along with timely medical attention in male partners of infertile couples can improve the semen quality.

scholarly journals Laparoscopy as a diagnostic tool in evaluation of female factors in infertility

2017 ◽  
Vol 6 (3) ◽  
pp. 864 ◽  
Author(s):  
Chaitra Krishna ◽  
Prathima S. ◽  
Savitha Chandraiah ◽  
Anitha G. S.
Keyword(s):  
Diagnostic Laparoscopy ◽  
Polycystic Ovary ◽  
Well Being ◽  
Common Finding ◽  
Infertile Couple ◽  
Polycystic Ovaries ◽  
Male Factor ◽  
Secondary Infertility ◽  
Infertile Women ◽  
Primary Infertility

Background: Infertility leads to considerable personal suffering and disruption of family life. According to United Nations "Reproductive health is a state of complete physical mental and social well-being and not merely the absence of disease or infirmity in all matters relating to the reproductive system and to its functions and processes". The objective of present study was to find out different causes of female infertility with diagnostic laparoscopy and their comparative frequency in primary and secondary infertility.Methods: It is a prospective study conducted on all infertile women and they underwent diagnostic laparoscopy for primary and secondary infertility during the study period. Couples who had not lived together for at least 12 months, and those with male factor infertility were excluded. Data were collected on a proforma, and analyzed on SPSS package for windows version 10. Frequencies were calculated for laparoscopic findings regarding primary and secondary infertility.Results: Fifty infertile women underwent laparoscopy during the study period, 35 (70%) had primary infertility while 15 (30%) secondary infertility. 10 (28.5%) patients with primary and 3 (20%) patients with secondary infertility had no visible abnormality. The common finding was tubal blockage in 10 (28.5%) and 5 (33.3%) cases of primary and secondary infertility respectively. 9 (25.7%) cases of primary infertility were detected as polycystic ovaries (PCO) and 2 (13.3%) in cases of secondary infertility. Endometriosis was found in 1 case with primary infertility and 2 (13.3%) cases with secondary infertility. Fibroid was found in 3 (8.57%) and 1 (6.6%) cases of primary and secondary infertility respectively.Conclusions: Most common causes responsible for infertility were tubal occlusion and polycystic ovary. Infertile couple should be thoroughly investigated. Laparoscopy in infertility can be used for a definitive diagnosis.

scholarly journals Depressive morbidity among female partner of infertile couple in a tertiary care setup in Bangladesh

2019 ◽  
Vol 45 (2) ◽  
pp. 93-98
Author(s):  
Tanzeem S Chowdury ◽  
T A Chowdhury ◽  
Shirin Akter Begum ◽  
Yasmin Begum ◽  
Mehriban Amatullah
Keyword(s):  
Assisted Reproductive Technologies ◽  
Tertiary Care ◽  
Severe Depression ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Unprotected Sexual Intercourse ◽  
Female Partners ◽  
Primary Infertility ◽  
Infertile Couples ◽  
Anxiety Depression

Background: There are 80 million infertile couples in the world which correspond to approximately 15% of all couples in their reproductive age. Negative attitude and behavior of family and acquaintances causes severe psychological stress resulting in social discrimination and stigmatization which may lead to anxiety, depression and even suicide. The study was aimed to estimate the prevalence and predictors of depressive morbidity among Bangladeshi infertile women. Methods: This prospective, observational study was done on a total of 215 female partners of infertile couples who attended ‘Infertility Management Center’; a Dhaka based tertiary care setup for infertility management and assisted reproductive technologies from August - December 2016. Only those who were unable to conceive after one year of unprotected sexual intercourse and agreed to take part in the study were included in the study. Patients with history of mental illness prior to infertility diagnosis and on any anti-psychotic drugs were excluded from the study. Data collection was done using the validated Beck Depression Inventory (BDI) questionnaire. Results: Among the study population 72.6% were suffering from primary infertility and 27.4% from secondary infertility. Of them, 52.6% had 5 to 10 years and 47.4% had various duration of infertility. Female cause of infertility was in 30.7% couples, male cause was in 16.3%, both were in 4.7% and finally unknown was 48.4%. Female partners of infertile couples showed different types of mode disorders such as 29.3% (n=63) having severe depression, 39.5% moderate, 20.5% mild and 10.7% having no depression. Association between educational status and depression score showed 53.02% graduate having severe depression, though statistically it was not significant. Depression was most common among patients suffering from primary infertility and among housewives as they probably had more time to think and feel the situation. Conclusion: The high level of depression among female partners of infertile couples revealed in this study is quiet alarming and requires attention of the medical fraternity. This study proposes that clinicians should be more aware about anxiety-depression disorders among infertile groups and the necessity of identifying patients who require psychological assistance. Bangladesh Med Res Counc Bull 2019; 45: 93-96

STUDY OF LAPAROSCOPIC EVALUATION OF FEMALE FACTORS IN INFERTILITY AT ANMMCH, GAYA, BIHAR

2021 ◽  
pp. 60-62
Author(s):  
Pankaj Kumar Chaudhary ◽  
Anupam Chaurasia ◽  
Lata Shukla Dwivedy ◽  
Debarshi Jana
Keyword(s):  
Diagnostic Laparoscopy ◽  
Polycystic Ovaries ◽  
Male Factor ◽  
Secondary Infertility ◽  
Infertile Women ◽  
Medical College ◽  
Primary Infertility ◽  
Common Causes ◽  
Tubal Blockage ◽  
Laparoscopic Evaluation

Objective:To nd out different causes of female infertility with diagnostic laparoscopy and their comparative frequency in primary and secondary infertility. Study Design:Acase series. Place and Duration of Study: Department of Obstetrics and Gynaecology, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, August 2018 to July 2019. Methodology:All infertile women underwent diagnostic laparoscopy for primary and secondary infertility during the study period were included. Couples who had not lived together for at least 12 months, and those with male factor infertility were excluded. Data were collected on a proforma, and analysed on SPSS package for windows version 10. Frequencies were calculated for laparoscopic ndings regarding primary and secondary infertility. Results: Fifty infertile women underwent laparoscopy during the study period, 32 (64%) had primary infertility while 18 (36%) secondary infertility. Eight (25.0%) patients with primary and 2 (11.1%) patients with secondary infertility had no visible abnormality. The common nding was tubal blockage in 7 (21.9%) and 6 (33.3%) cases of primary and secondary infertility respectively. Five (15.6%) cases of primary infertility were detected as polycystic ovaries (PCO) which was not found in cases of secondary infertility. Endometriosis was found in 4 (12.5%) cases with primary infertility and 2 (11.1%) cases with secondary infertility. Pelvic inammatory disease (PID) was found in 1 (3.1%) and 2 (16.7%) cases of primary and secondary infertility respectively. Peritubal and periovarian adhesions were detected in 2 (6.3%) cases with primary infertility and 4 (22.2%) cases with secondary infertility. Fibriod was found in 2 (6.3%) and 1 (5.6%) cases of primary and secondary infertility respectively. Ovarian cyst detected in 2 (6.3%) cases with primary infertility while none was found in cases of secondary infertility. Conclusion: Most common causes responsible for infertility were tubal occlusion, endometriosis, peritubal and periovarian adhesions. Ovarian causes were seen in primary infertility only

scholarly journals Role of diagnostic hystero-laparoscopy in the evaluation of female infertility

2019 ◽  
Vol 8 (8) ◽  
pp. 3156
Author(s):  
Deepa Shanmugham ◽  
Nambala Divya Sahitya ◽  
Sindhu Natarajan ◽  
Deepak Kannan Saravanany
Keyword(s):  
Tertiary Care ◽  
Reproductive Age ◽  
Polycystic Ovaries ◽  
Tertiary Care Centre ◽  
Male Factor ◽  
Acute Pelvic Inflammatory Disease ◽  
Tubal Factor ◽  
The Mean ◽  
A Prospective Study

Background: Infertility affects about 10-15% of reproductive age couples. The main causes of infertility include male factor, ovulatory disorders, tubal factor and endometriosis. This study was conducted to determine the role of Diagnostic hystero-laparoscopy (DHL) in the evaluation of female infertility.Methods: This study was a prospective study done in a tertiary care centre over a period of 1 year on all infertile couples. The exclusion criteria: male factor infertility, hypothyroidism, hyperprolactinemia, acute pelvic inflammatory disease. Diagnostic hysterolaparoscopy was performed in all study patients in pre ovulatory phase, under general anaesthesia. The findings were then documented and analysed.Results: A total number of 90 patients were recruited for the study. The mean age of the patients was 28±3 years. The mean BMI of the study patients was 25±4 kg/m2. The mean duration of infertility was 5.4 years. On laparoscopy, 28 patients had polycystic ovaries (31.1%), 4 patients had pelvic adhesions (4.4%), 2 patients had endometriosis (2.2%) and tubal block was identified in 10 patients (11.11%). 10 patients had abnormal findings on hysteroscopy.Conclusions: Hystero laparoscopy is an effective diagnostic tool in the evaluation of infertility and has to be included in basic diagnostic workup.

scholarly journals Laparoscopic Evaluation of Female Factor in Bangladeshi Infertile Couple

2019 ◽  
Vol 33 (1) ◽  
pp. 29-35
Author(s):  
Umme Ruman ◽  
TA Chowdhury ◽  
Nusrat Mahmud ◽  
Tanjeem S Chowdhury ◽  
Samira H Habib
Keyword(s):  
Clinical History ◽  
Cross Sectional Study ◽  
Pelvic Surgery ◽  
Treatment Modalities ◽  
Infertile Couple ◽  
Polycystic Ovaries ◽  
Male Factor ◽  
Secondary Infertility ◽  
Cross Sectional ◽  
Primary Infertility

Background: Infertility prevails in good number in our society, causing social disharmony and distress. Laparoscopy is now a very effective tool for diagnosis and evaluation of female infertility. Method: This cross sectional study was conducted in Infertility Unit of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, from July, 2012 to June 2014. The aim of the study is to identify common pelvic pathologies of female factor infertility by laparoscopy so that early detection and treatment modalities can be instituted. Total 230 sub fertile patients attending OPD were selected for this study. Patients with DM, HTN, known case of hypothyroidism and male factor infertility was excluded from study. Detailed clinical history of every patient was recorded on a pre-set questionnaire and physical examination was performed. Laparoscopy was scheduled in proliferative phase of menstrual cycle. Results: Among the study subjects, 130 (56.5%) had primary infertility while 100 (43.5%) secondary infertility. On laparoscopy, 64.4% patient had normal sized uterus, 31 % had bulky uterus. Two patients had bicornuate uterus in secondary infertility cases. Uterus was restricted in mobility in 41% of patients due to endometriosis, pelvic inflammatory disease (PID) or previous pelvic surgery. Fibroid uterus was detected in 30(13%) and 10(4.3%) cases of primary and secondary infertility cases respectively. Bilateral tubal blockage was present in 16(6.9%) and 17 (7.4%) cases of primary and secondary infertility respectively. Forty (17.4%) cases of primary infertility were detected as polycystic ovaries (PCO) which was 30(13%) in cases of secondary infertility. Endometriosis was found in total 9(3.9%) patient in both the groups. Pelvic adhesion was found in 22(9.5%) and 21 (9.1%) cases of primary and secondary infertility respectively. Conclusion: Laparoscopy could diagnose a substantial number of portion pelvic pathology. In a developing country like Bangladesh, earlier and justified intervention with laparoscopy can save time and expense of infertility treatment by diagnosing pelvic factor responsible for infertility. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 29-35

Epidemiology of Male Infertility at a Tertiary Hospital in Eastern India

2016 ◽  
Vol 8 (2) ◽  
pp. 101-106
Author(s):  
Rezaul Karim ◽  
KM Umashankar ◽  
Jayeeta Mukherjee ◽  
Ramya Cristy ◽  
Bhaskarananda Seal ◽  
...  
Keyword(s):  
Male Infertility ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
World Health ◽  
Semen Parameters ◽  
Care Hospital ◽  
Age Group ◽  
Eastern India ◽  
Male Factor ◽  
Infertile Men

ABSTRACT Introduction The prevalence of infertility in the general population is 15 to 20%. Of this, the male factor is responsible for 20 to 40%. In Indian couples seeking treatment, the male factor is the cause in approximately 23% of the cases. In a World Health Organization multicenter study, 45% of infertile men were found to have either oligozoospermia or azoospermia. A study from a tertiary care hospital in India reported 58% azoospermia and 24% oligozoospermia in infertile men. Aims and objectives To analyze the epidemiology of male infertility. Results In this study of 100 cases of male infertility, 64% of the patients are in the age group 25 to 35 years, 31% of the patients are in the age group of >35 to 45 years, 4% of the patients are in the age group of more than 45 years, and 1% of the patients are in the age group of <25 years. Of the total patients, 34% (n = 37) are business people, 5% (n = 5) are clerks, 2% (n = 2) are contractors, 13% (n = 13) are drivers, 2% (n = 2) are factory workers, 6% (n = 6) are farmers, 5% (n = 5)are government workers, 3% (n = 3) each are hotel workers and jute mill workers, and 2% (n = 2) each are laborers, painters, and tea stall workers. Conclusion Male infertility is multifactorial: Age, occupation, and habits have a significant impact on the seminal parameters. Modifiable behaviors like cessation of smoking and alcohol are cost-effective in normalizing the semen parameters and thereby restoring fertility. How to cite this article Umashankar KM, Mukherjee J, Cristy R, Seal B, Karim R, Ray CD, Bandyopadhyay S, Biswas J. Epidemiology of Male Infertility at a Tertiary Hospital in Eastern India. J South Asian Feder Obst Gynae 2016;8(2):101-106.

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