Zakaria, Siti Aisyah
(2015)
Factors associated with successful outcome of infertility threatment at Hospital Raja Perempuan Zainab II.
Masters thesis, Universiti Sains Malaysia.
Abstract
Infertility is defined as the inability to conceive after a year of regular
unprotected intercourse. Different treatment modalities are available to treat
infertility ranging from simple, non-invasive oral agent such as clomiphene citrate to
invasive procedure such as assisted reproductive technology (ART). The objective of
this cross-sectional study was to determine the factors associated with the successful
outcome of infertility treatment at Hospital Raja Perempuan Zainab II. Out of 429
cases, only 117 cases that fulfilled the inclusion creiteria were included. A
retrospective record review was done using a checklist proforma consisting of
sociodemography (age, ethnicity, education level and employment status), female
variables (menstrual history, infertility history, sexual history, medical and surgical
history, investigations, causes and treatment), male variables (smoking status,
medical and surgical history, seminal fluid analysis, the last treatment method and its
outcome ( success or failure). The successful outcome of treatment was categorised
into intrauterine pregnancy, abortion or extrauterine pregnancy. The end outcome for
intrauterine pregnancy was assessed in terms of mode of delivery (SVD or LSCS)
and the fetal outcome (singleton or multiple births and gestational age). The
descriptive methods and multiple logistic regression were applied to answer the
objectives and hypotheses of this study. The overall successful rate post infertility
treatment was 20.5% (95% CI: 16.8%, 24.2%) which resulted in thirteen intrauterine
pregnancies, ten abortions and one extrauterine pregnancy. All thirteen pregnancies
resulted in singleton babies, seven were delivered via SVD and six delivered via
LSCS for precious pregnancy (two cases), fetal distress (2 cases) and one case of
placenta praevia. Two of the babies were prematured, and the rest were delivered at
term. Analysis from logistic regression showed that age of menarche (adj OR=
1.59,95% CI: 1.05, 2.42, p-value= 0.030) was the only significant factor affecting the
successful outcome of infertility treatment when adjusted for age of men and
women, BMI, duration of infertility, smoking, sperm characteristics (sperm count,
percentage of progressive motility and normal morphology) and treatment options.
The proportion of women with successful outcome post infertility treatment was
almost similar to other studies and the odds of having a successful outcome are much
higher in women with late age of menarche.
Keywords: Infertility, intrauterine pregnancy, extrauterine pregnancy, abortion, age
of menarche.
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