A PROSPECTIVE STUDY TO EVALUATE THE ETIOLOGICAL FACTORS OF FEMALE INFERTILITY AND TO ASSESS THE TUBAL FACTORS IN TERTIARY CARE HOSPITAL IN SOUTH RAJASTHAN
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Keywords
Female infertility, Tubal factors, Secondary infertility
Abstract
Infertility is a major global public health concern with significant medical, psychological, and social implications. It is multifactorial, with both male and female factors contributing. Tubal pathology remains a leading cause in low- and middle-income countries. Region-specific studies are essential for guiding management. This study aimed to evaluate the etiological factors of female infertility and assess the contribution of tubal pathology in women attending a tertiary care hospital in South Rajasthan.
Materials and Methods: A prospective cohort study was conducted from May 2023 to April 2024 in the Department of Obstetrics and Gynecology, Pacific Institute of Medical Sciences, Udaipur. A total of 100 infertile women aged 20–40 years were enrolled based on defined criteria. Data on demographic, menstrual, and reproductive profiles were collected. All participants underwent transvaginal ultrasonography (TVS) and hysterosalpingography (HSG), with selected cases evaluated using diagnostic hysterolaparoscopy. Hormonal assays were performed, and male partners underwent semen analysis. Data were analyzed using SPSS v26, with results expressed as frequencies, percentages, sensitivity, and specificity.
Results: The mean age of participants was 29.6 years; most were 21–30 years (50%) or 31–40 years (46%). Secondary infertility (63%) was more prevalent than primary infertility (37%). Tubal factors included endometriosis (25%), chronic pelvic inflammatory disease (24%), prior tubal surgery (23%), ectopic pregnancy (21%), and tuberculosis (14%). Male factor infertility was observed in 32% of couples. Abnormal USG/HSG findings were seen in 53% of women. Female imaging demonstrated limited predictive value for male infertility (sensitivity 59.4%, specificity 50%).
Conclusion: Infertility in South Rajasthan is marked by predominant secondary infertility, significant tubal pathology, and notable male contribution. Comprehensive evaluation of both partners and preventive measures targeting pelvic infections and modifiable risk factors are essential to improve outcomes.
References
2. Carson SA, Kallen AN. Diagnosis and Management of Infertility: A Review. JAMA. 2021;326(1):65-76.
3. Sharma R, Bakshi H, Patel P, et al. Burden of Infertility, Its Risk Factors, Perceptions and Challenges Faced by Women of Peri-urban Community from Ahmedabad City: Mixed Method Study. Indian J Community Med. 2024;49(5):687-694
4. Xie Y, Ren Y, Niu C, et al. The impact of stigma on mental health and quality of life of infertile women: A systematic review. Front Psychol. 2023; 13:1093459.
5. Emokpae MA, Brown SI. Effects of lifestyle factors on fertility: practical recommendations for modification. Reprod Fertil. 2021;2(1):13-26.
6. Agiwal V, Madhuri RS, Chaudhuri S. Infertility Burden Across Indian States: Insights from a Nationally Representative Survey Conducted During 2019-21. J Reprod Infertil. 2023;24(4):287-292.
7. Howe S, Zulu JM, Boivin J, et al. The social and cultural meanings of infertility for men and women in Zambia: legacy, family and divine intervention. Facts Views Vis Obgyn. 2020;12(3):185-193.
8. Speizer IS, Pearson E. Association between early marriage and intimate partner violence in India: a focus on youth from Bihar and Rajasthan. J Interpers Violence. 2011;26(10):1963-81.
9. Sangwan RK, Huda RK, Khetan M, et al. Low birth weight and associated factors in rural population of Rajasthan, India. Front Glob Womens Health. 2025; 6:1587991.
10. Ahmad A, Suman MK, Hussain N, et al. An Overview of Male and Female Infertility: Etiology, Risk Factors, and Treatment Approaches. Acta Scientific Medical Sciences. 2024;8(9):70-78.
11. El-Kharoubi AF. Tubal Pathologies and Fertility Outcomes: A Review. Cureus. 2023;15(5): e38881.
12. Parua S, Purkait MP, Bhattacharjee A, et al. Exploring Female Infertility: A Comprehensive Review of Polycystic Ovary Syndrome (PCOS) and Its Impact on Reproductive Health. Obesity Medicine. 2025; 55:100619.
13. Singh K, Kumari R, Ranjan A, Bharti G. Analysis of causes and clinical pattern of infertility in couples coming to a tertiary care centre in Bihar, India. Int J Reprod Contracept Obstet Gynecol. 2017;6(6):2279-83.
14. Khanuja PK, Sunny JA, Pawar SB. Study on Infertility-Etiology, Medication Therapy Management and Outcomes at a Tertiary Care Hospital. International Journal of Infertility & Fetal Medicine. 2017;8(3):106-12.
15. Patel A, Sharma PS, Narayan P, et al. Prevalence and predictors of infertility-specific stress in women diagnosed with primary infertility: A clinic-based study. Journal of human reproductive sciences. 2016;9(1):28-34.
16. Soni M, Kumari S. Prospective evaluation of causes of infertility at a tertiary care hospital. International Journal of Research in Medical Sciences. 2018;6(12);3988–3992.
17. Eraky EM, Seif El-Nasr EM. Risk factors of secondary infertility among women attending outpatient clinic at Cairo University Hospital; suggested guideline. World J Nurs Sci. 2016;2(1):1-10.
18. Mayrhofer D, Holzer I, Aschauer J, et al. Incidence and Causes of Tubal Occlusion in Infertility: A Retrospective Cohort Study. Journal of Clinical Medicine. 2024;13(13):3961.
19. Anwar BR, Fatima P, Afza N, et al. Aetiological Factors of infertility: A study done in Bangabandhu shekh Mujib Medical University (BSMMU) Hospital- A Tertiary Level hospital in Bangladesh. J Dhaka Med Coll. 2012;21(2):152-155.
20. Umeora OU, Mbazor JO, Okpere EE. Tubal factor infertility in Benin City, Nigeria-sociodemographics of patients and aetiopathogenic factors. Tropical doctor. 2007;37(2):92-4.
21. Nanaware SS, Saswade M, Shende PN, et al. Role of hysterolaparoscopy in the evaluation of female infertility in tertiary care centre. Int J Contem Med Res. 2016;3(10):3063-5.
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Dr Charulata Purbia
Assistant Professor, Department of Obstetrics and Gynaecology, Pacific Institute of Medical Sciences, Sai Tirupati University, Umarda, Udaipur, Rajasthan, India.
Dr Anshu Lohchab
Junior Resident, Department of Obstetrics and Gynaecology, Pacific Institute of Medical Sciences, Sai Tirupati University, Umarda, Udaipur, Rajasthan, India.
Dr Pooja Rao
Junior Resident, Department of Obstetrics and Gynaecology, Pacific Institute of Medical Sciences, Sai Tirupati University, Umarda, Udaipur, Rajasthan, India.