Study on probable aetiological factors of subfertility in a tertiary care hospital


Ovulatory dysfunction

How to Cite

Tamrakar, S. R., & Lamsal, M. . (2022). Study on probable aetiological factors of subfertility in a tertiary care hospital. Journal of Kathmandu Medical College, 11(3), 142–147. Retrieved from


Background: Subfertility refers to describe women or couple who are not sterile but exhibit decreased reproductive efficiency even after 12 months of regular unprotected intercourse.

Objectives: To find probable aetiological factors in subfertile couples attending Dhulikhel Hospital.

Methods: This descriptive cross-sectional study was conducted among 140 subfertile couples in Dhulikhel Hospital from March 2016 to December 2017 after ethical clearance. The participants were recruited by convenience sampling, data were entered in Microsoft Excel Sheet and analysed using SPSS v.23. Descriptive statistics like frequency, percent, mean, and standard deviation have been presented.

Results: Among 140 subfertile couples, mean duration of subfertility was 5.55 ± 3.96 years. About two-thirds (95, 67.9%) of them were of primary subfertility. Most subfertile clients (both) were of 26-30 years age group and about three-fifths (83, 59.3%) were of Janajati caste. The most common cause of subfertility was female factor (72, 51.4%) only. Ovulatory dysfunction (49, 35%) followed by tubal abnormalities (24, 17.1%) were major female contributory factors. Thyroid disorder was noted in 19 (13.6%) clients and hyperprolactinaemia was observed in 14 (10%) subfertile female clients. Two (1.4%) female clients had diabetes mellitus and 24 (17.1%) had evidence of different forms of genital infection. Only male factor contributed was seen in 16 (11.4%) clients and asthenozoopermia was the commonest abnormal semen parameters. Six (4.3%) males with abnormal semen parameter were working abroad.

Conclusion: Ovulatory causes was found to be the commonest cause of subfertility in Dhulikhel Hospital. Asthenooospermia was the most common male factor.



Fritz MA, Speroff L, eds. Infertility.Clinical Gynecologic Endocrinology and Infertility. 8th ed. Philadelphia, USA: Lippincott Williams and Wilkins, Wolter Kluwer; 2011.1137-90p. [Full Text]

Dutta DC. Infertility. In: Konar H, ed. Text Book of Gynaecology. 7th ed. New Delhi, India: Jaypee Brothers Medical Publishers (P) Ltd; 2015. 227-58 p. [Full Text]

Meng Q, Ren A, Zhang L, Liu J, Li Z, Yang, Y,et al. Incidence of infertility and risk factors of impaired fecundity among newly married couples in a Chinese population. Reprod Biomed Online. 2007;30(1):92- 100. [PubMed | Full Text | DOI]

Rijal B, Shrestha R, Jha B. Association of thyroid dysfunction among infertile women visiting infertility center of Om Hospital, Kathmandu, Nepal. Nepal Med Coll J. 2011;13(4):247-9. [PubMed | Full Text]

Pant PR. Factors affecting male infertility. J Inst Med. 2009;31(3):10-2. [Full Text | DOI]

Tamrakar SR, Bastakoti R. Determinants of infertility in couples. J Nepal Health Res Counc. 2019Jan-Mar;17(42):85-9. [PubMed | Full Text | DOI]

Subedi S, Lamichhane S, Chhetry M. Study of infertile couples attending a teaching hospital in Eastern Nepal. J Nepal Med Assoc. 2016;55(203):22- 5. [PubMed | Full Text | DOI]

Poonam. The role of hysterosalpingography in cases of subfertility. Kathmandu Univ Med J. 2007OctDec;5(4):456-60. [PubMed | Full Text]

Bhattarai M, Pokhrel (Ghimire) S. Hysterosalpingographic evaluation of uterus and fallopian tubes of infertile women. J Nobel Med Coll. 2017;6(1):63-71. [Full Text | DOI]

Manandhar R, Manandhar BL, Sharma J. Thyroid profile in infertile women. Nepal Med J 2018;01(01):5- 10. [Full Text]

Banu F. Correlation of serum prolactin and thyroid hormone in female infertility. J Nepalgunj Med Coll. 2019;17(2):32-4. [Full Text | DOI]

Shrivastava T, Pokhrel US, Shrestha S, Shrestha S. Assessing the possible risk factors of male infertility. Fertil Sci Res. 2018;5:60-4. [Full Text | DOI]

Masoumi SZ, Parsa P, Darvish N, Mokhtari S, Yavangi M, Roshanaei G. An epidemiologic survey on the causes of infertility in patients referred to infertility center in Fatemieh Hospital in Hamadan. Iran J Reprod Med. 2015;13(8):513-6. [PubMed | Full Text]

Sultana A, Tanira S, Adhikari S, Keya KA, Akhter S. Explained infertility among the couple attending the infertility unit of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh. J Dhaka Med Coll. 2014;23(1):114-20. [Full Text | DOI]

Anwar BR, Fatima P, Afza N,Tarannum T, Begum N, Kulsum SU et al. Etiologic factors of infertility in a referral hospital (BSMMU, Bangladesh). J Med. 2013;14(2):110-3. [Full Text | DOI]

Karki S, Suwal S, Tamrakar S, Poudel R. Imaging in infertile female patients who underwent hysterosalpingography investigation at Dhulikhel Hospital. Kathmandu Univ Med J. 2016;14(3):258-63. [PubMed | Full Text]

Palihawadana T, Wijesinghe P, Seneviratna H. Aetiology of infertility among females seeking treatment at a tertiary care hospital in Sri Lanka. Ceylon Med J. 2012;57(2):79-83. [PubMed | Full Text | DOI]

Rahim R, Majid SS. Aetiological factors of infertility. J Postgr Med Inst. 2004;18(2):166-71. [Full Text]

Kamali M, Baghestani A, Kashfi F, Kashani H, Tavajohi S, Chaghmaghi A. A survey on infertility in Royan institute. Int J Fertilty Steril. 2003;1(1):23-6. [Full Text | DOI]

Osman AA. Aetiology of female infertility in Gezira (Central of Sudan). J Appl Sci. 2010;10(19):2333-37. [Full Text | DOI]

Farrokh D, Layegh P, Afzalaghaee M, Rastegar YF. Hysterosalpingographic findings in women with genital tuberculosis. Iran J Reprod Med. 2015;13:297- 304. [PubMed | Full Text]

Heertum K Van, Barmat L. Uterine fibroids associated with infertility. Womens Health (London). 2014;10:645-653. [PubMed | Full Text | DOI]

Ozkan S, Murk W, Arici A. Endometriosis and infertility: epidemiology and evidence-based treatments. Ann N Y Acad Sci. 2008;1127:91-100. [PubMed | Full Text | DOI]

Subedi SS, Bhansakarya R, Shrestha P, Sharma SK. Outcome of laparoscopy in infertile couples attending a teaching hospital in eastern Nepal: A descriptive cross-sectional Study. J Nepal Med Assoc. 2020;58(231):889-92. [PubMed | Full Text | DOI]

Arojoki M, Jokimaa V, Juuti A, Koskinen P, Irjala K, Anttila L. Hypothyroidism among infertile women in Finland. Gynecol Endocrinol. 2000;14(2):127-31. [PubMed | Full Text | DOI]

Kumar N, Singh A. Trends of male factor infertility, an important cause of infertility: A review of literature. J Hum Reprod Sci. 2015;8(4):191-6. [PubMed | Full Text | DOI]

Chowdhury MA, Haque MM, Chowdhury S, Prodhania MS. Determinants of infertility among couples seeking treatment in aselected clinic in Dhaka city. Chattagram Maa-O-Shishu Hosp Med Coll J. 2014;13(3):42-5. [PubMed | Full Text]

Sharma R, Harlev A, Agarwal A, Esteves SC. Cigarette smoking and semen quality: A new meta-analysis examining the effect of the 2010 World Health Organisation laboratory methods for the examination of human semen. Eur Urol. 2016;70:635-45. [PubMed | Full Text | DOI]