Investigating Infertility Causes, Obesity Rates, and Mental Status of Infertile Females Attending the Infertility Center at Azadi Teaching Hospital in Kirkuk City, Iraq

Abstract

Introduction: Worldwide; Infertility is a very challenging condition which brings about significant stressful that effects many individuals and couples. Obesity has become a widespread global issue and has reached epidemic extents with a negative impact on individual's body system including the reproductive system. Infertility can have profound impacts on the emotional well-being and overall quality of life of those affected, often leading to feelings of disappointment and even clinical depression. 
 Objective: This study aims to determine the frequency of causes of infertility among infertile women attending the infertility center in Azadi Teaching Hospital in Kirkuk City, Iraq, as well as, the relation of the duration of infertility to it. Furthermore, to find the prevalence of obesity among those women, assess the rate of depression and anxiety and investigate factors related to them. 
 Subjects & Methods: In this cross-sectional study, one hundred infertile females participated. Information was obtained from all the patients from medical and laboratory findings. A questionnaire about demographic data was designed for all the patients. The psychological status of patients was evaluated by administering the Hospital Anxiety Depression Scale (HADS) test.
 Results: The most leading cause of infertility was Poly cystic Ovarian Syndrome (PCOS). There were statistically significant differences among the groups of the study regarding the period of infertility the nature of the disorder, 39% of PCOS patients experienced 2-3-year infertility. While 50% of patients with male factors infertility expressed +15-year infertility, 30.9% of patients with mixed male and female factors of infertility expressed 5–9-year infertility. The percentage of primary and secondary infertility was 61.8 and 38.2, respectively. 76.7% of the women who participated were overweight or obese; only 22.3% being of normal weight. 60% of PCOS patients were overweight, and 53% of infertile women with ovulatory causes rather than PCOS were overweight. Just 18% of infertile females consume a healthy diet; furthermore, 80% of them express an uncontrolled weight. Regarding the anxiety HADS score,74 % of infertile women with infertility periods more than four years old expressed an anxiety score above 7 (borderline). 27.7% of infertile women over 40 years old express an abnormal anxiety HADS score. The percentage of abnormal depression on the HADS score in young infertile women was 4.3%, while it was 8.3% in infertile women over 40 years old. 
 Conclusion: PCOS is the most typical cause of infertility in this study. However, there may be other causes of infertility rather than PCOS for long periods of infertility. Among participating infertile women, obesity is prevalent. According to the study's findings, infertility has a significant influence on women in our society and can cause a variety of psychological symptoms, including depression and anxiety.