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


  • Kalpana Singh Department of Reproductive Biology, Department of Biochemistry, IGIMS, Patna, Bihar, India
  • Rekha Kumari Department of Reproductive Biology, Department of Biochemistry, IGIMS, Patna, Bihar, India
  • Alok Ranjan Department of Community and Family Medicine, AIIMS, Patna, Bihar, India
  • Geetam Bharti Department of Community and Family Medicine, AIIMS, Patna, Bihar, India



Cause, Female factor, Infertility, Male factor, Pattern


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.


World Health Organization (WHO). Mother or nothing: The agony of infertility. WHO Bulletin. 2010; 88:877-953.

Inhorn MC. Global infertility and the globalization of new reproductive technologies: Illustrations from Egypt. Soc Sci Med. 2003;56:1837-51.

World Health Organisation. 1994. Challenges in reproductive health research, Biennial report 1992-1993, Geneva.

World Health Organization. Infecundity, infertility, and childlessness in developing countries. DHS Comparative Reports No 9. Calverton, Maryland, USA: ORC Macro and the World Health Organization; 2004.

Talwar PP, Go OP, Murali IN. Prevalence of infertility in different population groups in India and its determinants. In: Statistics and demography. New Delhi: National Institute of Health & Family Welfare & Indian Council of Medical Research; 1986.

Unisa S. Childlessness in Andhra Pradesh, India: Treatment seeking and consequences. Reprod Health Matters. 1999; 7: 54-64.

Zargar AH, Wani AI, Masoodi SR, Laway BA, Salahuddin M. Epidemiologic and etiologic aspects of primary infertility in the Kashmir region of India. Fertil Steril. 1997;68:637-43.

Kumar D. Prevalence of female infertility and its socioeconomic factors in tribal communities of Central India. Rural Remote Health. 2007;7:456.

Jejeebhoy SJ. Infertility in India - levels, patterns and consequences: priorities for social science research. J Family Welfare. 1998;44(2):15-24.

Ganguly S, Unisa S. Trends of Infertility and Childlessness in India: Findings from NFHS Data. Facts Views Vis Obgyn. 2010;2 (2):131-8.

Adamson PC, Krupp K, Alexandra H, Freeman AH, Klausner JD, Arthur L et al. Prevalence and correlates of primary infertility among young women in Mysore, India. Indian J Med Res. 2011;134:440-6.

Panti AA, Sununu YT. The profile of infertility in a teaching Hospital in North West Nigeria. Sahel Med J. 2014;17(1):7-11.

Okonofua FE, Odunsi K. Infertility in Sub –Saharan Africa. Contemporary obstetrics and gynaecology for developing countries. Publishers: Women’s Health and Action Research Centre. Benin city. 2003.p.128-56.

Templeton A, Fraser C, Thompson B. Infertility-epidermiology and referral practice. Hum Reprod. 1991;6:1391-4.

Chowdhary MA, Haque MM, Choudhary S,Prodhania MS. Determinants of Infertility Among Couples Seeking Treatment in A Selected Clinic in Dhaka City. Chattagsam Maa-O-Shishu Hospital Med College J. 2014;13(3):42-5.

Bayasgalan et al. Clinic pattern and major causes of infertility in Mangolia. Obstet Gynaecol Res. 2004;30(5):386-93.

Masoumi SZ, Parsa P, Darvish N, Mokhtari S, Yavangi M, Roshanaei G. 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.

Fathi J, Haroush Ben. Distribution of causes of infertility in patients attending primary fertility clinics in Isreal. Isreal Med Assoc J. 2011;13:51-4.






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