Iranian Society of Gynecology Oncology

Document Type : Original Research Article


1 College of Medical Technology,Medical Lab techniques, Al-farahidi University/ Iraq

2 Al-Nisour University College, Iraq

3 Anesthesia Techniques Department, Al-Mustaqbal University College, Babylon, Iraq

4 The University of Mashreq, Baghdad, Iraq

5 Department of pharmacy, Ashur University College, Baghdad, Iraq

6 Al-Esraa University College, Baghdad, Iraq

7 Department of Nursing, Al-Zahrawi University College, Karbala, Iraq

8 Al-Kafeel University, College of Health and Medical Technologies, Department of Medical Laboratory Technologies, Iraq


Background & Objective: Infertility is the inability to become pregnant despite trying for at least a year. Infertility is also referred to as when a woman continues to experience miscarriages. Environmental factors, lifestyle, hormone issues, physical problems, and age can all contribute to female infertility. About 10-12% of couples struggle with infertility, a multifaceted issue with ramifications for society, the economy, and culture. The majority of female infertility cases are caused by issues with egg production. By analyzing samples from infertility clinics, the current study aims to investigate the degree of female infertility in Erbil, Iraq, while covering all facets of the condition.
Materials & Methods: 595 infertile females receiving medical counseling from three infertile institutions between February 2020 to December 2021 were screened for the current study. In addition to anthropometric measurements, information about the etiology, duration, and lifestyle, factors of infertility has been gathered using a standardized questionnaire. Additionally, the sample was subjected to clinical examinations. Five groups of reproductive abnormalities were identified. Around 61.79% of women in the infertile group for the first two years had tubal obstruction, and 49.92% had hormonal deficiencies. Ovulation defects (4.62%) and undersized uteri (4.82%) predominated in the >10-year infertile group. Both weight and body mass index have shown a favorable association with infertility duration.
Results: Our findings demonstrated a significant correlation between body mass index and infertility. Most academic and wealthy groups pursued medical advice to resolve issues related to infertility.
Conclusion: Finally, it is suggested that female infertility can be managed and cured with hormone therapy, laparoscopic procedures, minor surgical procedures, and medicine.


 Finally, it is suggested that female infertility can be managed and cured with hormone therapy, laparoscopic procedures, minor surgical procedures, and medicine.


Main Subjects

1. Carson SA, Kallen AN. Diagnosis and Management of Infertility: A Review. JAMA. 2021;326(1):65-76. [DOI:10.1001/jama.2021.4788] [PMID] [PMCID]
2. Vander Borght M, Wyns C. Fertility and infertility: Definition and epidemiology. Clin Biochem. 2018;62:2-10. [DOI:10.1016/j.clinbiochem.2018.03.012] [PMID]
3. Insogna IG, Ginsburg ES. Infertility, Inequality, and How Lack of Insurance Coverage Compromises Reproductive Autonomy. AMA Journal of Ethics. 2018;20(12):E1152-9. [DOI:10.1001/amajethics.2018.1152] [PMID]
4. Alamin S, Allahyari T, Ghorbani B, Sadeghitabar A, Karami MT. Failure in Identity Building as the Main Challenge of Infertility: A Qualitative Study. J Reprod Infertil. 2020;21(1):49-58.
5. Fainberg J, Kashanian JA. Recent advances in understanding and managing male infertility. F1000Res. 2019;8:F1000 Faculty Rev-670. [DOI:10.12688/f1000research.17076.1] [PMID] [PMCID]
6. Nagórska M, Bartosiewicz A, Obrzut B, Darmochwał-Kolarz D. Gender Differences in the Experience of Infertility Concerning Polish Couples: Preliminary Research. Int J Environ Res Public Health. 2019;16(13):2337. [DOI:10.3390/ijerph16132337] [PMID] [PMCID]
7. Hawksworth DJ, Szafran AA, Jordan PW, Dobs AS, Herati AS. Infertility in Patients With Klinefelter Syndrome: Optimal Timing for Sperm and Testicular Tissue Cryopreservation. Rev Urol. 2018;20(2):56-62.
8. Weiss NS, Kostova E, Nahuis M, Mol BWJ, Veen F van der, Wely M van. Gonadotrophins for ovulation induction in women with polycystic ovary syndrome. Cochrane Database System Rev [Internet]. 2019 [cited 2022 Jun 25];(1). [DOI:10.1002/14651858.CD010290.pub3] [PMID] [PMCID]
9. Sharpe A, Morley LC, Tang T, Norman RJ, Balen AH. Metformin for ovulation induction (excluding gonadotrophins) in women with polycystic ovary syndrome. Cochrane Database System Rev [Internet]. 2019 [cited 2022 Jun 25];(12). [DOI:10.1002/14651858.CD013505]
10. Jones BC, Hahn AC, DeBruine LM. Ovulation, Sex Hormones, and Women's Mating Psychology. Trend Cog Sci. 2019;23(1):51-62. [DOI:10.1016/j.tics.2018.10.008] [PMID]
11. McWhirter M, McQueen D. Rationing and NHS fertility services: A commissioning perspective. Hum Fertil. 2000;3(4):271-4. [DOI:10.1080/1464727002000199121] [PMID]
12. Peterson B, Boivin J, Norré J, Smith C, Thorn P, Wischmann T. An introduction to infertility counseling: a guide for mental health and medical professionals. J Assist Reprod Genet. 2012;29(3):243-8. [DOI:10.1007/s10815-011-9701-y] [PMID] [PMCID]
13. Burnett JA. Cultural Considerations in Counseling Couples Who Experience Infertility. J Multicul Counsel Develop. 2009;37(3):166-77. [DOI:10.1002/j.2161-1912.2009.tb00100.x]
14. Cousineau TM, Domar AD. Psychological impact of infertility. Best Prac Res Clin Obstet Gynaecol. 2007;21(2):293-308. [DOI:10.1016/j.bpobgyn.2006.12.003] [PMID]
15. Höbek Akarsu R, Kızılkaya Beji N. Spiritual and Religious Issues of Stigmatization Women with Infertility: A Qualitative Study. J Relig Health. 2021;60(1):256-67. [DOI:10.1007/s10943-019-00884-w] [PMID]
16. Brugo-Olmedo S, Chillik C, Kopelman S. Definition and causes of infertility. Reprod BioMed Online. 2001;2(1):173-85. [DOI:10.1016/S1472-6483(10)62193-1] [DOI:10.1016/S1472-6483(10)62187-6] [PMID]
17. Tinneberg H-R, Gasbarrini A. Infertility today: The management of female medical causes. Int J Gynecol Obstet. 2013;123:S25-30. [DOI:10.1016/j.ijgo.2013.09.004] [PMID]
18. Deshpande PS, Gupta AS. Causes and Prevalence of Factors Causing Infertility in a Public Health Facility. J Hum Reprod Sci. 2019;12(4):287-93. [DOI:10.4103/jhrs.JHRS_140_18] [PMID] [PMCID]
19. Nasser AM, Al-Jumaili EF, Alhusni ZK. The effect of pituitary hormones levels and relationship to female infertility in Baghdad province. J Phys: Conf Ser. 2021;1853(1):012015. [DOI:10.1088/1742-6596/1853/1/012015]
20. Brassard M, AinMelk Y, Baillargeon J-P. Basic Infertility Including Polycystic Ovary Syndrome. Medical Clinics of North America. 2008;92(5):1163-92. DOI: [DOI:10.1016/j.mcna.2008.04.008] [PMID]
21. Jahan Z, Wing KE. Polycystic Ovary Syndrome and its Relationship with Infertility and its Management. Journal of Bangladesh College of Physicians and Surgeons. 2021;39(1):53-8. [DOI:10.3329/jbcps.v39i1.50458]
22. Pfieffer ML. Polycystic ovary syndrome: Diagnosis and management. Nur Practit. 2019;44(3):30-5. [DOI:10.1097/01.NPR.0000553398.50729.c0] [PMID]
23. Binita G, Suprava P, Mainak C, Koner BC, Alpana S. Correlation of Prolactin and Thyroid Hormone Concentration with Menstrual Patterns in Infertile Women. J Reprod Infertil. 2009;10(3):207-12.
24. Bulletti C, Coccia ME, Battistoni S, Borini A. Endometriosis and infertility. J Assist Reprod Genet. 2010;27(8):441-7. [DOI:10.1007/s10815-010-9436-1] [PMID] [PMCID]
25. Swift BE, Liu KE. The Effect of Age, Ethnicity, and Level of Education on Fertility Awareness and Duration of Infertility. J Obstet Gynaecol Can. 2014;36(11):990-6. [DOI:10.1016/S1701-2163(15)30412-6] [PMID]
26. Vilarino FL, Christofolini DM, Rodrigues D, de Souza AMB, Christofolini J, Bianco B, et al. Body mass index and fertility: is there a correlation with human reproduction outcomes? Gynecol Endocrinol. 2011;27(4):232-6. [DOI:10.3109/09513590.2010.490613] [PMID]
27. Surrey ES, Schoolcraft WB. Evaluating strategies for improving ovarian response of the poor responder undergoing assisted reproductive techniques. Fertility and Sterility. 2000;73(4):667-76. [DOI:10.1016/S0015-0282(99)00630-5] [PMID]
28. Zain MM, Norman RJ. Impact of Obesity on Female Fertility and Fertility Treatment. Womens Health (Lond Engl). 2008;4(2):183-94. [DOI:10.2217/17455057.4.2.183] [PMID]
29. Miller LM, Wallace G, Birdsall MA, Hammond ER, Peek JC. Dropout rate and cumulative birth outcomes in couples undergoing in vitro fertilization within a funded and actively managed system of care in New Zealand. Fertil Steril. 2021;116(1):114-22. [DOI:10.1016/j.fertnstert.2021.01.041] [PMID]
30. 3Domar AD. Impact of psychological factors on dropout rates in insured infertility patients. Fertil Steril. 2004 Feb 1;81(2):271-3. [DOI:10.1016/j.fertnstert.2003.08.013] [PMID]
31. Mintziori G, Nigdelis MP, Mathew H, Mousiolis A, Goulis DG, Mantzoros CS. The effect of excess body fat on female and male reproduction. Metabolism. 2020;107:154193. [DOI:10.1016/j.metabol.2020.154193] [PMID]
32. Marchand GB, Carreau A-M, Weisnagel SJ, Bergeron J, Labrie F, Lemieux S, et al. Increased body fat mass explains the positive association between circulating estradiol and insulin resistance in postmenopausal women. Am J Physiol Endocrinol Metabol. 2018;314(5):E448-56. [DOI:10.1152/ajpendo.00293.2017] [PMID]
33. Kaarouch I, Bouamoud N, Madkour A, Louanjli N, Saadani B, Assou S, et al. Paternal age: Negative impact on sperm genome decays and IVF outcomes after 40 years. Mol Reprod Dev. 2018;85(3):271-80. [DOI:10.1002/mrd.22963] [PMID]
34. Salliss ME, Farland LV, Mahnert ND, Herbst-Kralovetz MM. The role of gut and genital microbiota and the estrobolome in endometriosis, infertility and chronic pelvic pain. Hum Reprod Update. 2022;28(1):92-131. [DOI:10.1093/humupd/dmab035] [PMID]
35. Rungsiwiwut R, Virutamasen P, Pruksananonda K. Mesenchymal stem cells for restoring endometrial function: An infertility perspective. Reprod Med Biol. 2021;20(1):13-9. [DOI:10.1002/rmb2.12339] [PMID] [PMCID]
36. Lee D, Kim SK, Lee JR, Jee BC. Management of endometriosis-related infertility: Considerations and treatment options. Clin Exp Reprod Med. 2020;47(1):1-11. [DOI:10.5653/cerm.2019.02971] [PMID] [PMCID]