Evaluation of Female Infertility Factors: A Prospective Observational Study

Abstract

Aims: The present study evaluates the factors associated with female infertility. This is a prospective observational study of 100 woman in reproductive age group with complaints of primary and secondary infertility. Study Design:  Prospective observational study. Place and Duration of Study: Department of Obstetrics and Gynaecology at our tertiary care centre. Methodology: 100 women (mean age: 24.68 years) in reproductive age group with complaints of primary and secondary infertility were included. A comprehensive history was taken from the participants covering their socio-demographic background, menstrual patterns, obstetric details, and medical history. Thorough general and systemic examinations were conducted with particular attention to pelvic examination for clinical assessment. All symptoms, clinical findings, and examination results were systematically recorded. Ultrasonography was performed to assess the pelvic organs, including the uterine cavity, endometrial thickness, and any adnexal abnormalities. Hysterolaparoscopy was undertaken in cases requiring further investigation, and the findings were duly noted. Results: Tubal factors were the major causes of primary and secondary infertility accounting for 43.9% and 38.2% respectively. PCOS was the major pathological reason among ovarian factors for primary infertility (24.4%) and secondary infertility (20%). With regards to peritoneal factors endometriosis (13.3%) and tuberculosis (16%) were responsible for primary and secondary infertility respectively. With respect to uterine factors Mullerian pathology was found to be the major cause for primary (8.9%) and secondary (12%) infertility in women. Ovarian factors were the major causes of primary infertility identified through hysterolaparoscopy, and which is accounting for 55.6% followed by peritoneal factors (35.6%), tubal factors (33.3%), and uterine factors (24.4%). Similarly, with respect to secondary infertility in women ovarian factors identified through hysterolaparoscopy accounts for 52% followed by tubal factors (40%), peritoneal factors (36%), and uterine factors (24%). Conclusion: Hysteroscopy combined with laparoscopy remains the only diagnostic method that allows direct visualization of the female reproductive system to identify the underlying causes of infertility.