Epidemiologic and etiologic aspects of primary infertility in the Kashmir region of India

Abstract

Objective: To assess the magnitude of primary infertility and to study its etiologic aspects in India.

Design: After proper randomization, 10,063 married couples were interviewed to ascertain the prevalence of primary infertility. A definitive protocol was followed to determine the etiology of primary infertility in 250 consecutive couples.

Setting: Tertiary care medical center in the Kashmir valley of India.

Patient(s): Couples married for > or = 1 year; 250 consecutive couples attending an endocrine clinic for primary infertility.

Intervention(s): A logical investigative protocol was followed to identify the etiology of infertility.

Main outcome measure(s): Magnitude of primary infertility in the community as well as the male, female, or combined etiology of infertility.

Result(s): Fifteen percent of the couples interviewed had primary infertility, among whom 4.66% had unresolved infertility at the time of the survey. The etiology of infertility in 250 consecutive couples revealed a female factor in 57.6%, a male factor in 22.4%, combined factors in 5.2%, and an undetermined cause in 14.8%.

Conclusion(s): Primary infertility is as common and distressing a problem in India as in other parts of the world. Semen abnormalities (22.4%), anovulation (17.2%), ovarian failure (8.8%), hyperprolactinemia (8.4%) and tubal disease (7.2%) are common causes of infertility. The pattern of infertility in India is the same as in other parts of the world, except that infertile couples report late for evaluation.