Title: An evaluation of etiologic factors and therapy in 555 private patients with primary infertility.

POPLINE Document Number: 018221

Author(s):

Jones GS
Pourmand K

Source citation:

Fertility and Sterility, 1962 Sep-Oct;13(5):398-410.

Abstract:

Some 12 years ago a form was designed for the tabulation of information in the study of infertility and female endocrine disorders in an effort to collect data suitable for coding and mechanical sorting. This study deals with the records so tabulated of 555 consecutive private patients complaining of primary infertility. The evaluation of etiologic factors is obviously subject to individual bias in many instances. The final diagnosis was made with the use of all findings and, in some cases, a retrospective diagnosis, not possible at the patient's initial study, was made. An effort was made to use only therapeutic measures which were indicated by the physical or laboratory findings, but as the investigation and therapy of these patients was carried over a 12-year period, changes in therapeutic approaches occurred. Follow-up information was available for 542 of the 555 patients. Of the 542, 204 or 37.4%, were known to have achieved a pregnancy. This correlated wtih the age of the patients and the duration of the inferitliy to as great an extent as the etiologic factor responsible for that infertility. Of the 315 patients between the ages of 20-35 years with infertility of 1 or more years duration who had completed the study or had 5 or more visits, 143 or 46% achieved a pregnancy. 28 pregnancies terminated in abortions, 7 in premature delivery of a normal child, and 1 in an ectopic pregnancy. Surgical therapy for the entire group of 55 patients was as follows: 16 tubal plastic procedures; 7 myomectomies; 29 endometrial resections; 8 cervical procedures; 15 ovarian wedge resections, and 3 vaginal plastic procedures consisting of removal of a vaginal septum. There were 131 patients with infertility primarily due to tubal factors. The etiology of the tubal pathology was not determined in the majority of the cases. An effort was made to subdivide further the cases in the category of ovarian factors according to the estimated etiology of the ovarian failure: Stein-Leventhal Syndrome; unknown dysfunction; ovarian failure; nutritional insufficiency; chronic disease; metabolic disease; neurological and psychogenic disease. 65 patients, in addition to the 17 reported under tubal factors, had endometriosis. There wre a total of 54 couples in whom the infertility was judged to be due to male factors, with no additional factors found in the wife. 20 patients had infertility judged to be due primarily to a cervical factor. 9 patients had anatomical abnormalities of the uterus. In 3 patients age was found to be the etiologic factor, with no other factor detectable. In addition to 4 patients reported under ovarian factors, there were 15 patients in whom malnutrition was judged to be the sole cause of infertility. 11 patients, in addition to the 9 reported under ovarian factors, were diagnosed as having infertility due to psychogenic factors. 9 patients had infertility primarily due to intercourse problems, and 90 patients were classified as having infertility of unknown etiology.

Keywords:

Retrospective Studies
Infertility
Treatment
Surgery
Ovarian Effects
Psychological Factors
Endometritis
Endometrial Effects
Age Factors
Population Characteristics
Cervical Effects
Malnutrition
Nutrition Disorders
Sex Behavior
Studies
Research Methodology
Reproduction
Ovary
Genitalia, Female
Genitalia
Urogenital System
Physiology
Biology
Behavior
Reproductive Tract Infections
Infections
Diseases
Endometrium
Uterus
Demographic Factors
Population
Cervix