Risk Factors and Clinical Patterns of Infertility in Couples: A Hospital-based Cross-sectional Study in Southern Khyber Pakhtunkhwa, Pakistan

Infertility is ranked as the fifth-leading cause of disability in the world's population under 60 years old, according to the World Health Organization, affecting an estimated 80 million people worldwide. This reproductive health disorder can be caused by various factors, including structural, biological, and congenital issues, as well as acquired and environmental variables. To investigate the prevalence and potential risk factors of infertility, a hospital-based cross-sectional study was conducted in district Kohat, Pakistan, from January to May 2021. A total of 120 infertile couples were recruited from the outpatient center at Liaquat Memorial Hospital, and their medical files were reviewed, followed by face-to-face interviews with both partners of each couple. Of the participants, 47.5% were suffering from primary infertility, while 52.5% were affected by secondary infertility. Female infertility was the most common form of infertility, affecting 49.16% of couples, followed by male infertility (15.83%), couples with both partners facing infertility issues (8.33%), and unspecified infertility (26.66%). The most frequent causes of male and female infertility were erection issues (48.27%) and hormonal imbalances (40.57%), respectively. Additionally, 46.34% of couples reported stress and anxiety, and 14.16% had a history of assisted reproductive technology. Furthermore, 18.3% of couples had a family history of infertility, with 77.27% of those affected being infertile females. Infertile couples were also assessed based on potential risk factors, including age difference, age at menarche, occupation, smoking, and BMI. These findings may aid in identifying the factors contributing to infertility among the population.