Summary:
Background: Motherhood is an integral part of womanhood
and being childless is a devastating experience for a woman
in developing countries like Bangladesh. Majority of patients
in developing countries have virtually no access to treatment.
Few health facilities have provision for proper diagnosis
and treatment for infertility. There is a general lack of
awareness among the public regarding infertility. In the
quest for conception, many couples adopt for alternative
therapies and religious rituals killing crucial age and time.
Objective: To find out the treatment seeking behavior and
the profile of infertile patients attending a tertiary infertility
center at Dhaka, Bangladesh .
Methods: During a period of five years from January 2001
to December 2005, 8580 new patients attending a tertiary
infertility center at Dhaka were included in the study.
Results: Treatment seeking behavior of infertile patients
attending Center for Assisted Reproduction, (CARe) Dhaka
revealed 30% of the patients initially go to the traditional
healers for the relief of infertility, 36% consult both
traditional healers and doctors and 32% consulted with GP
and Gynae specialist, and only 2% came straight to the
tertiary center( CARe) for their subfertility. 55% of the patients
attending the clinic were from urban area and 45% were
from rural area. The maximum number of patients were
from Dhaka division followed by Chittagong, Khulna,
Barisal, Sylhet and Rajshahi. The overall primary and
secondary infertility were in 63.34% and 36.66% of the
patients respectively. 90% of the patients were Muslim and
9% were Hindu and 1% were from other religion. Only
32.37 % of the patients took treatment in the clinic for their
infertility. Male factor problems as identified among the
male partners of the infertile couples were azoospermia in
18%, abnormal semen parameter in 24%,and normal semen
parameter in 58 %. Among the female partners completing
investigations, 17% suffered from anovulation, 20% from
premature ovarian failure and 3% from ovarian failure ,
with a total of 40% of the women suffering from ovarian
factor, 8% suffered from endometriosis, 7% from bilateral
tubal block, 3% from uterine factor problem. In 42% women
there was no apparent cause in the females. Untreatable
causes of infertility among the infertile couples were in
3.75% of the patients. Ovarian failure was in 3% cases,
testicular failure in 0.5% and uterine factor in 0.25% of
cases. 75% of the women were less than thirty five years of
age where as 29 % of the males were less than 35 years.
Conclusion: Causes of infertility vary from region to region
so also social and cultural conditions. Financial condition
also affects the health seeking behavior of the patients. For
the purpose of management of infertile couples the cause
of infertility is important to understand so that the options of
treatment and the prognosis can be discussed with the patients.
(J Bangladesh Coll Phys Surg 2016; 34: 140-144)