Cause of infertility and response to ovulation induction drugs -a hospital based study

ABSTRACT

This study was performed to investigate the most common causes of infertility and the choice of the more suitable and more easily achievable treatment. A detail history and physical examination were done for all the patients who were referred to Mahdishahr Hospital with chief complaint of infertility from October 2004 to September 2005. Patients who failed to become pregnant after unprotected intercourse for 1 year were chosen as the criteria for to this study. At first semen analysis was performed for all couples. Among the patients who were complaining of oligomenorrhea, galactorrhea or in their laboratory test hyperprolactinemia was found, the treatment started with ovulation induction drugs. In all these groups of patients endometrial thickness and the size of follicles was measured by sonography in the 13th days of their period, among the patients with two or four follicles bigger or equal to 18 mm [If they were treated with clomiphene citrate, bromocriptine or dexamethasone] or when two or four follicles were bigger or equal to 16 mm [if they were treated with Human Menopausal Gonadotropin [HMG] and endometrial thickness or equal to 6mm and Human Chorionic Gonadotropin [HCG] Ampoule [10000 unit] was injected. All these patients were followed to control their response to the treatment and during the whole period of pregnancy. In the other patients hystrosalpingography or post-coital test used for finding the cause of infertility. In 57% of the patients [40 persons] there were symptoms of oligomenorrhea, galactorrhea or hyperprolactinemia. For these patients ovulation induction is started by clomiphene citrate, bromocriptine, dexamethasone and HMG. 27 cases [67%] of them conceived. Term pregnancy with normal child in 20 cases, abortion in 5 cases and unexpected preterm birth both in 21 weeks of pregnancy happened. Twenty eight percent [20 cases] of cause of infertility was male factor. 7% [5 cases] and 1/4% [lease] of causes were tubal and cervical factors respectively. It's concluded that the most common cause of infertility in Mahdishahr is the ovulatory factor. Other causes respectively are male-factor, tubal, cervical, and other factors. Besides, in a large percent of these patients who were treated by ovulation induction pregnancy happend which is noticeable