Study of the causes and the results of treatment in infertile couples at Thammasat Hospital between 1999-2004.

OBJECTIVE: To study the type, cause, pregnancy rate, and pregnancy outcome of infertile couple in Fertility Clinic of Thammasat Hospital, Thammasat University. MATERIAL AND METHOD: The retrospective study was performed by reviewing the data of infertile couples attending the Fertility Clinic of Thammasat Hospital from 1999 until 2004. The data included age, type of infertility, duration, causes, treatments, and results of treatment of the infertile couples and excluded the data from the cancellation treatment cycles. RESULTS: One thousand seventy two infertile couples revealed 61.8% of primary infertility, 35.6% ofsecondary infertility, and 2.5% of incomplete data record. The overall duration of infertility was mostly between 1-4 years in 58.3%. The age of 65.9% of female partners and 61.2% of male partners were between 30-39 years. The causes of infertility were found in both partners (55.6%), only in male partners (19.4%), only in female partners (17.5%), in unexplained cause (4.7%), and in incomplete data group (2.8%). The causes of female infertility were endometriosis, tubal, ovulatory, uterine, endocrinnological, pelvic factors, and unexplained causes were found in 25.6%, 12.4%, 11.8%, 9.1%, 9.0%, 1.7%, and 25.7% of cases respectively. The causes of male infertility were terato, oligoasthenoterato, asthenoterato, astheno, oligoterato, oligo, asthenooligo, azoospermia, and unexplained causes found in 25.4%, 14.4%, 12%, 2.0%, 1.0%, 0.4%, 0.3%, 4.5%, and 24.2%, respectively. The pregnancy rate of IUI was 14.8% of which 95.5% succeeded in three attempts, where those of IVF, ICSI and ICSI- PESA were 32.3%, 28.0%, and 35.3%, respectively. The outcomes of pregnancy from IUI were 71.6% singleton, 1.5% twins, 1.5% triplets, 19.4% abortion, and 6.0% ectopic pregnancy. The outcomes of pregnancy from IVF were 30% singleton, 20% twins, 40% abortion, and 10% ectopic pregnancy. The outcomes of pregnancy from ICSI were 56.5% singleton, 17.4% twins, 13% triplets, and 13% abortion. Finally, the outcomes of pregnancy from ICSI-PESA were 66.7% singleton, 16.7% twins, and 16.7% abortion. CONCLUSION: Primary infertility cases were more common than secondary infertility cases. More than half of the infertile couples causes were from both male and female partners. The causes of male and female factors were similar to other reports, such as abnormal semen analysis, endometriosis, tubal factor and ovulatory factor The pregnancy rate and pregnancy outcome of IUI, IVF and ICSI were comparable with the other reports.