Hematology in the Road To Motherhood, Hematological Parameters in Patients Visiting ART (Assisted Reproductive Technology) Centre

ABSTRACT

Introduction: Infertility is a clinically common disease, occurring in approximately 10% of women of childbearing age. There is a paucity of studies investigating hematological parameters among infertile women and the association of anemia with infertility. Aims & Objectives: To estimate the prevalence of anemia and the haematological profile among women undergoing infertility treatment. Material(s) and Method(s) This is a cross-sectional single centre descriptive study from Western India. Patients visiting artificial reproductive (ART) centre aged between 18-50 years and were cohabitating with husband for at least six months during the study period (Jan 2021 to Sep 2022) were screened for inclusion. Patients with chronic kidney disease, chronic liver disease, malignancy, on chemotherapy for any malignancy, taking drugs interfering with Iron/ Vitamin B12/Folic acid metabolism and diabetes mellitus were excluded from the study. All included patients were subjected to CBC using 7-part coulter and those with any haematological abnormality were further assessed by haematologist for establishing firm diagnosis. Those patients who didn't give consent for detailed evaluation or those who were lost to follow up because of COVID were excluded from the study. Data was analysed using JMP ver 16.0.0. Result(s) Study population included 108 patients with a mean age of 28.30 +/- 4.14y. Eighty percent of the study population were home makers. Average annual family income was 7.55 +/- 1.47 lakhs per year. The mean duration of infertility being 5.95 +/- 3.52 years with most of them having primary infertility (81%). RBC characteristics of study population being, Hb- 12.12 +/- 1.07 g/dL, MCV- 81.57 +/- 7.12fL, PCV-36.72 +/- 2.88%, RBCs-4.52 +/- 0.45million/ lL, MCH-26.99 +/- 2.86 pg, MCHC-33.02 +/- 1.11 g/L, and RDW- 14.96 +/- 2.17. Other hematological profiles of the infertility patients revealed a total leukocyte count of 7439 +/- 1897/muL, Platelets- 2.53 +/- 0.90/lL. Of all the patients 43% had anemia at presentation to the infertility clinic. Among those who had anemia 52% had microcytic hypochromic whereas 46% had normocytic normochromic with 2% having macrocytic anemia. Among those with microcytic hypochromic anaemia, the mean Mentzer index was 15.53 +/- 2.40. Irrespective of anemia status, 30% of patients had microcytosis. Most of the patients with microcytic hypochromic anemia had Iron deficiency with one two patients having BTT. The prevalent anemia was not higher than the background prevalence. None of the patients had any leukocyte or platelet disorders. Conclusion(s) There is no predominant haematological association with female infertility.