Causes of Male and Female Sub Fertility in the Couples who Underwent ‘In Vitro Fertilization’ at Life Clinic; a Statistical Study from Lahore, Pakistan
Keywords:
Sub fertility, Females, Males, Causes, Lahore, PakistanAbstract
Objective:To explore the causes of male and female sub fertility in the couples undergoing ‘In Vitro Fertilization’ at LIFE
clinic. Materials and Methods: In this retrospective, cross-sectional, observational study from Lahore, Pakistan all couples coming
for evaluation and treatment for sub-fertility from 1st January to 30th April 2015 at Lahore institute of fertility and endocrinology
LIFE with n=344 patients were included Fertility and Endocrinology (LIFE). Sampling method was non probability consecutive.
The data collection instrument was an especially designed Performa. Causes of Sub fertility male and female were studied and
data was extracted from the files of LIFE.
Results:Out of 344 patients 138(40.1%) had female factors, 122(35.5%) had male factor, 38(11.0%) had combined factors
whereas 46(13.4%) had unexplained infertility. Out of 138, 55(39.85%) females had tubal factor, 2(1.45%) had endometriosis,
21(15.22%) had PCO and 60(43.47%) had unexplained causes of sub-fertility. Out of 122 males, 90 (74.4%) had
oligospermia/asthenospermia and 32(25.6%) had azoospermia.
Conclusion:Tubal factor was a major cause of sub-fertility in females whereas in 2/3 of the females, cause of sub-fertility was
not explained.Among the males,oligospermia was the most common cause and was found in 74.4%. Health education about
menstrual hygiene should be imparted early in life to prevent Sub-fertility due to infection. Premarital counseling and testing
should be made easily available. Andrology should be made part of the Gynecology courses and curricula. Community based
Sub-fertility research should be encouraged to assess the disease burden and frequency of preventable causes.
References
Begum BN, Hasan S. Psychological problems among
women with infertility problem: a comparative study. J Pak Med Assoc.2014;64(11): 1287-91
Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA. National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med. 2012;9(12):e1001356
Maheshwari A, Hamilton M, Bhattacharya S. Effect of female age on the diagnostic categories of infertility. Hum Reprod 2008;23(3):424-538
Bhattacharya S, Maheshwari A, Mollison J .Factors Associated with Failed Treatment: an Analysis of 121,744 Women Embarking on TheirFirst IVF Cycles. PLoS ONE 2013;8(12): e82249
Adamson PC, Krupp K, Freeman AH, Klausner JD, Reingold AL, Madhivanan P. Prevalence & correlates of primary infertility among young women in Mysore, India. Indian J Med Res. 2011;134:440-6
Son WY, Das M, Shalom-Paz E, Holzer H. Mechanisms of follicle selection and development. Minerva Ginecol. 2011;63(2):89-102
Stouffer RL, Bishop CV, Bogan RL, Xu F, Hennebold JD. Endocrine and local control of the primate corpus luteum. Reprod Biol. 2013;13(4):259-71
Zeleznik AJ. The physiology of follicle selection. Reprod Biol Endocrinol. 2004; 16;2:31
Abou-Setta AM, Mansour RT, Al-Inany HG, Aboulghar MM, Aboulghar MA, Serour GI. Among women unde- rgoing embryo transfer, is the probability of pregnancy and live birth improved with ultrasound guidance over clinical touch alone? A systemic review and meta-anal- ysis of prospective randomized trials. Fertil Steril. 2007; 88(2):333-41
Ammar T, Sidhu PS, Wilkins CJ. Male infertility: the role of imaging in diagnosis and management.
Br J Radiol. 2012;85 Spec No 1:S59-68
Gratton RJ, Nisker JA, Daniel S, Toth S, Gunter J, Kapl- an BR, et. al. An aggressive philosophy in controlled ovarian stimulation cycles increases pregnancy rates. Hum Reprod. 1993;8(4):528-31
Campbell S Ash Monga; Gynaecology by Ten Teachers (18th ed.). Hodder Education.2006 ISBN 0-340-81662-7
Psychoyos A Endocrine control of egg implantation. In: Handbook of Physiology 1973 Volume II, Part 2 pp 187- 215 Eds RO Greep, EG Astwood and SR Geiger. Ameri- can Physiological Society, Washington DC
Hickey M, Balen A. Menstrual disorders in adolescence: investigation and management. Hum Reprod Update. 2003;9(5):493-504
Williams M, Hill CJ, Scudamore I, Dunphy B, Cooke ID, Barratt CL. Sperm numbers and distribution within the human fallopian tube around ovulation. Hum Reprod. 1993; 8(12):2019-26
Suarez SS, Pacey AA. Sperm transport in the female reproductive tract. Hum Reprod Update.2006;12(1):23- 37
Ali S, Sophie R, Imam AM, Khan FI, Ali SF, Shaikh A, et al. Knowledge, perceptions and myths regarding infertility among selected adult population in Pakistan: a cross-sectional study. BMC Public Health. 2011;(4);1 1:760
Chester R. Is there a relationship between childlessness
and marriage breakdown? J Biosoc Sci. 1972;4(4):443- 54
Ibeh U O, Obidoa M A. Marital Disharmony: Causes and resolution strategies in Enugu State of Nigeria. Research on Humanities and Social Sciences; 2013; 3(22), 40-8
Khan HL, Khan YL, Suhail S, Awais A, Khawaja AR. Characteristics of Female Patients Visiting for Assisted Reproductive Technology in a Private Clinic in Lahore Pakistan. J SZMC. 2014; 5(4): 715-20
Hasanpoor-Azghdy SB Vedadhir A. The emotional- psychological consequences of infertility among infertile women seeking treatment: Results of a qualitative study. Iran J Reprod Med 2014; 12(2): 131-8
Bergstrom S. Childlessness. In: Lawson J B, Harrison K A, Bergstrom S, editors. Maternity care in developing countries. RCOG PRESS; 2001. pp. 360-8
Whitman-Elia GF, Baxley EG. A primary care approach to the infertile couple. J Am Board Fam Pract. 2001;14(1)
:33-45
Swerdloff RS, Wang C, Kandeel FR. Evaluation of the infertile couple. Endocrinol Metab Clin North Am. 1988; 17(2):301-37
Cousineau Tara M, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol, 2007; 21: 293-308
Greil A L,Slauson-Blevins, K,Mc Quillan J. The experie- nce of infertility: A review of recent literature. Sociol Health Illn. 2010;32(1):140-62
Masoumi SZ, Parsa P, Darvish N, MokhtariS,Yavangi M, RoshanaeiG.An epidemiologic survey on the causes of infertility in patients referred to infertility center in Fatemieh Hospital in Hamadan. Iran J Reprod Med. 2015;13(8):513-6
Macaluso M, Wright-Schnapp T, Chandra A, Johnson R, Satterwhite C, Pulver A, et al. A public health focus on infertility prevention, detection, and management. Fertil Steri 2010; 93: 16
Elussein EA, Magid YM, Omer MM, Adam I. Clinical patterns and major causes of infertility among Sudanese couples. Trop Doct. 2008;38(4):243-4
Templeton A, Fraser C, Thompson B. Infertility-epidemi- ology and referral practice. Hum Reprod. 1991;6(10):13 91-4
Menuba IE, Ugwu EO, Obi SN, Lawani LO, Onwuka CI. Clinical management and therapeutic outcome of infertile couples in southeast Nigeria.Ther Clin Risk Manag.2014;10:763-8
Zargar AH, Wani AI, Masoodi SR, Laway BA, Salahud- din M. Epidemiologic and etiologic aspects of primary infertility in the Kashmir region of India. Fertil Steril. 1997;68(4):637-43
Bayasgalan G, Naranbat D, Tsedmaa B, Tsogmaa B, Su- khee D, Amarjargal O, et al Clinical patterns and major causes of infertility in Mongolia. J Obstet Gynaecol Res. 2004;30(5):386-93
Philippov OS, Radionchenko AA, Bolotova VP, WHO Estimation of the prevalence and causes of infertility in western Siberia. Bull 1998; 76: 183-7
Ferlin A, Arredi B, Speltra E. Molecular and clinical characterization of Y chromosome microdeletions in in- fertile men: a 10-year experience in Italy. J Clin Endoc- rinol Metab. 2007;92:762-70
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2016 Haroon Latif Khan, Yousaf Latif Khan, Nighat Mahmood, Mariam Mustanser, Saba Sardar, Abdul Rahman Khawaja
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0 
