FEMALE INFERTILITY

Objectives: To find the prevalence and etiology of female infertility as well asto study the associated biochemical abnormalities. Place and Duration of Study: Departmentof Gynecology, Frontier Medical & Dental College, Abbottabad, from July 2016 to June 2017.Study Design: Case-control study. Materials & Methods: All married patients between theages of 18-35 years were included in the study. Sixty patients who met eligibility criteria wereincluded in one group while sixty normal healthy individuals were included in the second groupas controls. Detailed history was taken focusing specifically on age and duration of marriage,menstrual and sexual history and drug history especially use of contraceptives. A thoroughclinical examination was performed by an experienced clinician and body mass index wascalculated. Laboratory investigations included complete blood examination, hormonal assays,ultrasonography in female patients and semen analysis in male partners. Tubal patency wasassessed by hysterosalpingography and laparoscopy was performed, if required. Results: Themean age of infertile patients was 27.4±4.9 years and mean duration of their marriage was6.6±2.9 years. Majority of patients in our study belonged to lower socio-economic status inboth groups. About 50% belonged to lower and 16.67% to poor socio-economic group amonginfertile subjects while 60% belonged to lower and 10% to poor socio-economic group amongcontrols. The chief presenting complaint was oligomenorrhea followed by galactorrhea anddyspareunia. The chiefunderlying condition was luteal phase deficiency, 60%, followed byhyperprolactinemia, 16.66%, and polycystic ovarian disease, 10%, fibroid uterus, 6.7%, andendometriosis, 6.7%. The serum estradiol levels were 114.6±48.7pg/ml and 233.2±70.8 pg/ml in follicular and luteal phase among infertile couples. Similarly, serum progesterone, serumprolactin, serum FSH and LH levels were 3.6±4.2 ng/ml, 18.1±12 ng/ml, 6.7±2.7 mIU/ml, and7±6.6 mIU/ml among infertile patients respectively. Serum estradiol and prolactin levels weresignificantly higher among infertile patients. Conclusion: Infertility is not a very uncommoncondition in our country. It is the need of time to increase awareness and educate massesabout infertility as well as establish infertility clinics for early detection and treatment of infertilecouples. Large scale multi-centric studies should also be conducted to accurately estimate theprevalence and etiology of infertility in our region.