Patterns of Infertility and Assisted Reproductive Outcomes: A Retrospective Study in Gynaecological Practice

Infertility forms a significant problem in society in South Asia and in Bangladesh, sociocultural imperatives about bearing children increase the effects of reproductive failure. Although there has been an increment in the access to infertility services and assisted reproductive technologies (ART), there is lack of comprehensive clinical data that have been attained through conventional gynaecological practice. The study objective is to assess the epidemiological trends, the etiological factors and ART outcomes in infertile couples who visited a tertiary infertility center in Dhaka, Bangladesh. Retrospective analysis of medical records was done between January 2020 and December 2023. There were a total of 612 couples who were unproductive and had inclusion criteria. Extracted data were demographic data, infertility site and duration, hormonal data, semen data, ultrasonographic results, tubal patency test, and the result of treatments conducted during ovulation induction (OI), intrauterine insemination (IUI) and in vitro fertilization/ intracytoplasmic sperm injection (ICSI). Inferential and descriptive statistics were used. Mean female age was 29.8 +- 4.6, and the mean male age was 34.7 +- 5.2. Primary infertility was major (71.4%). The incidences of female-factor, male-factor, combined factors and unexplained infertility were 47.9, 30.4, 12.7 and 9, respectively. Anovulation mainly PCOS (22.58) and tubal factor infertility (14.16) were the top female causes. Oligoasthenoteratospermia (17.3%), was the leading cause among males. OI, IUI and IVF/ICSI pregnancy rates were 9.6, 14.8 and 32.4 per OI cycle, IUI cycle and IVF/ICSI cycle, respectively. The dependent variable of ART success was linked to female age less than 35 years (p < 0.01), infertility duration less than 5 years (p < 0.05) and normal semen parameters (p < 0.05). Bangladesh infertility is a primary condition that can mostly be explained by ovulatory inefficiency and male-factor defects. The results of ART, especially IVF/ICSI, are on par with the local standards. To enhance the reproductive outcome, it is necessary to strengthen the early referral systems, enhance the examination of male infertility, and increase the availability of ART services.