Prevalence of Anovulation in Subfertile Women in Kerbala 2012, A descriptive Cross-Sectional Study

Ovulation is the result of a maturation process that occurs in the hypothalamic-pituitary-ovarian (HPO) axis and is orchestrated by a neuroendocrine cascade terminating in the ovaries. Any alteration results in a failure to release a mature ovum, leading to anovulatory cycles. Anovulation may manifest in a variety of clinical presentations, from luteal insufficiency to oligomenorrhea. Anovulation is not a disease but a sign, in much the same way that polycystic ovaries are the manifestation of a much larger disease process.Purpose of Study: The purpose of study was to find the prevalence of anovulation amongst subfertile women consulting infertility outpatient clinic in Karbala Maternity Hospital and we aim to assess the information found in patient clinical data files and the commitment of hospital to follow proper method to diagnosed the infertility and its causes. Materials and Methods:Location and time of study:Karbala Maternity Hospital from1st of January 2012-1st of January 2013.This is a retrospective study sampling the subfertile women consulting infertility outpatient clinic in Karbala Maternity Hospital during 2012. The Sample of study was 426 patients their files had been studied expeditiously exploring their investigations and follow-up. We took many information like age, type of infertility, occupation, ultrasonic features, Hysterosalpingography, and hormonal assays if available. There are many criteria that can be relied on to confirm anovulation however we revert for ultrasonic ones because other criteria were either missing or not well documented to depend on. Data Analysis was made by SPSS Program Version 16 and Chi square for the results obtained.Results and Discussion: The mean age of sample is 26.42 (SD 7.218) and most of the study population was house wives constituting about 91.3%. Ultrasonically confirmed anovulation constitutes about 58.1%, Confidence interval was 4.5% with confidence level of 95%. However, clinical data were missing for most of the patients.Dual Factors for infertility like anovulation and uterine abnormality constitutes 0.2%.Conclusion and Recommendations:Anovulatory infertility is by far the most common cause in both primary and secondary infertility in Karbala .Hormonal Assays are by far enormously important in investigating subfertile women; however they should be labeled at which time of the cycle they have been taken because interpretation differs and without labeling it makes revising the patient investigations useless and also complicates research issues.Clinical data in patient files were very primitive if present at all and this should be changed in future because there were clinical criteria for many disorders like Polycystic ovarian syndrome