Association between anthropometric indices and infertility among subfertile women: Insights from a single-centre cross- sectional study from Northern Sri Lanka

Abstract

Background: Obesity is a global concern affecting female fertility, with 6% of never-pregnant women facing fertility challenges due to obesity. This study aims to assess the association between Anthropometric Indices and Infertility Among Sub-fertile Women. Methodology: This hospital-based cross-sectional study included 216 infertile women aged 18 years and above attending sub-fertility clinics at Teaching Hospital, Jaffna. Data collection consisted of an interviewer-administered questionnaire, anthropometric measurements, and statistical analysis using SPSS Version 26. Body Mass Index (BMI) was categorised according to Sri Lankan Obesity standards, and Waist-Hip Ratio (WHR) according to Asian women’s standards. Results: In our study, 72.2% had primary sub-fertility, and 27.8% had secondary sub-fertility. The average age was 33.7 years (SD=7.12), with 38.9% of them older than 35 years, and 56.9% of them seeking therapy within five years of marriage, while 43.1% delayed treatment. Age and sub-fertility types showed a positive association (P=0.003). The majority (70.3%) were overweight, pre-obese, or obese, with 66.7% at risk based on WHR. Primary sub-fertility cases had a higher prevalence of Polycystic Ovary Syndrome (PCOS). There were no significant differences in BMI between individuals with PCOS (M=26.473, SD=5.58) and those without PCOS (M=25.23, SD=4.79) (t(214) = 1.701, p=0.90). Similarly, there was no significant difference in WHR between individuals with PCOS (M=0.887, SD=0.65) and those without PCOS (M=0.882, SD=0.83) (t(214) = 0.473, p=0.637). Conclusion: Our findings shows that most participants have elevated BMI and WHR. Despite observed trends, the lack of significant association between PCOS and anthropometric indices indicates that lifestyle, genetics, and hormonal factors may play a huge role in excessive body weight. Achieving optimal body weight through lifestyle changes in reproductive-age women is a cost-effective way to enhance fertility in low-middle-income countries.