Association between etiology of infertility & treatment success: Insights from 100 positive pregnancies in a Rural Hospital

Open Access

Abstract

Background: Infertility affects a significant proportion of women worldwide, with etiology influencing treatment outcomes. Polycystic ovary syndrome (PCOS) and other endocrine disorders are common contributors to infertility. Understanding the association between infertility causes and treatment success is essential for optimizing management, particularly in rural hospital settings. Methods & Materials: This observational study was conducted at Jahurunessa Hospital, Rupganj, Narayanganj, from June 2024 to May 2025. A total of 100 infertile women who achieved pregnancy following treatment were included. Patients were evaluated using detailed clinical history, physical examination, and relevant laboratory and imaging investigations. Exclusion criteria included incomplete records, severe systemic illness, and uterine anomalies incompatible with pregnancy. Ovulation induction protocols, primarily with letrozole, were used, with adjuvant therapies administered based on clinical need. Results: Most participants were aged 19–25 years (63%) and overweight (74%). Primary infertility accounted for 54%, with 62% having infertility for 2–3 years. PCOS was the leading etiology (62%), followed by unexplained infertility (12%) and hyperprolactinemia (9%). Single dominant follicle development occurred in 63% of cycles, with favorable endometrial thickness (9–11 mm) in 77% of patients. Ovulation was achieved within 2–4 cycles in 89% of cases. Pregnancy outcomes included 72% live births, 21% ongoing pregnancies, 5% abortion, and 2% ectopic pregnancies. Complications were uncommon (16%), including ovarian hyperstimulation syndrome (6%) and premature birth (5%). Conclusion: Conventional ovulation induction protocols, with individualized adjuvant therapy and careful cycle monitoring, resulted in favorable pregnancy outcomes among infertile women in this rural hospital setting.