Dr Hasna Hena Pervin, Assistant Professor, Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2022 Jul;31(3):690-695.
Infertility is a major reproductive health problem, at least in part, a cultural problem also. In developing countries like Bangladesh, infertility is a devastating experience for a couple, particularly in women. For this reason many women suffer from many social and medical consequences. Most of the infertile patients of Bangladesh have no access to adequate comprehensive treatment. Also due to lack of proper knowledge, some couples use varied traditional methods and religious practices. This study was done to assess the treatment seeking behavior of infertile couple and also to find out the gross causes of infertility of patients attending at Motherhood Fertility center, Dhaka, Bangladesh. This prospective study was done over 3 years from June 2016 to June 2019. Two thousand two hundred and fifty (2250) patients attending a secondary infertility center at Dhaka were included in this study. Out of 2250 infertile patients 56.00% were rural and 44.00% urban. Of 737 (58.49%) rural and 658 (66.46%) urban infertile patients had consulted with General practitioner and Gynae specialist before coming to secondary and tertiary care center. Out of 1260 rural, 463(36.75%) and 990 urban, 291 (29.39%) had visited the infertility center as the first choice for treatment. Still about 8.8% infertile couple visited quacks and traditional healers for solving infertility. The overall primary and secondary infertility were 67.69% and 32.31% respectively. In 12.57% couples, male factor was the obvious cause (azoospermia and abnormal semen parameters). In 27.43%, female factors and in 28.0% couples both male and female had obvious reasons responsible for infertility. Thirty two percent (32.00%) cases were unexplained infertility. Out of female factors 43.00% anovulation, 29.00% tubal factors, 11.00% endometriosis, 5.00% Uterine factors, 2.00% POF (premature ovarian failure) and 10.00% others (Thyroid disorder, DM, Hyper-prolactinemia, Luteal phase defect). Infertility is an important health problem in Bangladesh. Etiology of infertility varies from regional, social and cultural conditions so that it requires proper diagnosis and then treats this problem accordingly. It is necessary to build up proper referral system and also proper training should be needed to service provider and traditional healers. Reproductive technology should be widely available in our society where motherhood is one of the most desired stages of a women's life.
不孕不育是一个主要的生殖健康问题，至少在一定程度上也是一个文化问题。在孟加拉国等发展中国家，不孕不育对夫妇来说是一种毁灭性的经历，尤其是对女性而言。因此，许多女性遭受了许多社会和医疗方面的后果。孟加拉国的大多数不孕患者无法获得足够的综合治疗。此外，由于缺乏适当的知识，一些夫妇使用了各种传统方法和宗教习俗。本研究旨在评估不孕夫妇的治疗寻求行为，并找出在孟加拉国达卡的 Motherhood Fertility 中心就诊的患者不孕的主要原因。这项前瞻性研究是在 2016 年 6 月至 2019 年 6 月的 3 年内进行的。共有 2250 名在达卡二级不孕中心就诊的患者纳入本研究。在 2250 名不孕患者中，56.00%来自农村，44.00%来自城市。在 737 名（58.49%）农村和 658 名（66.46%）城市不孕患者中，有 58.49%和 66.46%在前往二级和三级保健中心之前曾咨询过全科医生和妇科专家。在 1260 名农村患者中，有 463 名（36.75%）和 990 名城市患者中，有 291 名（29.39%）将不孕中心作为治疗的首选。尽管如此，仍有约 8.8%的不孕夫妇选择庸医和传统治疗师来解决不孕问题。总的原发性和继发性不孕比例分别为 67.69%和 32.31%。在 12.57%的夫妇中，男性因素是明显的原因（无精子症和精液参数异常）。在 27.43%的情况下，女性因素和 28.0%的夫妇中，男女双方都有明显的原因导致不孕。32.00%的病例为不明原因不孕。在女性因素中，43.00%为无排卵，29.00%为输卵管因素，11.00%为子宫内膜异位症，5.00%为子宫因素，2.00%为卵巢早衰（POF），10.00%为其他因素（甲状腺疾病、糖尿病、高泌乳素血症、黄体期缺陷）。不孕不育是孟加拉国的一个重要健康问题。不孕不育的病因因地域、社会和文化条件而异，因此需要进行适当的诊断，然后相应地进行治疗。有必要建立适当的转诊制度，也需要对服务提供者和传统治疗师进行适当的培训。生殖技术应该在我们的社会中广泛应用，因为母性是女性生活中最理想的阶段之一。
