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Table of Contents

Chapter One…………………………………………………………………………..1

1.0 Introduction………………………………………………………………………………………...1

1.1 Background………………………………………………………………………………………….1

1.1.1 Infertility………………………………………………………………………........1-2

1.1.2 Female Infertility…………………………………………………………………..2-6

1.1.3 Male Infertility………………………………………………………………………….6

1.2 Epidemiology………………………………………………………………………………..........7

1.3 Statement of the Problem and Justification…………………………………..........7-8

1.4 Aim…………………………………………………………………………………………………….8

1.5 Objectives………………………………………………………………………………………….8-9

Chapter Two………………………………………………………………………….10

7

2.0 Literature Review…………………………………………………………………………………10

2.1 Causes of Infertility…………………………………………………………………………10-22

2.2 Hormonal Profile and Fertility Assessment…………………………………………22-24

Chapter Three…………………………………………………………………….…25

3.0 Materials and Methods……………………………………………………………………...25

3.1 Subjects…………………………………………………………………………………..........25

3.2 Study Site………………………………………………………………………………..........26

3.3 Sample Collection and Processing………………………………………………………26

3.4 Inclusion and Exclusion Criteria………………………………………………………….26

3.5.0 Methods…………………………………………………………………………………………..30

3.5.1 Follicle Stimulating Hormone………………………………………………..30-31

3.5.2 Luteinizing Hormone……………………………………………………………32-33

3.5.3 Prolactin…………………………………………………………………………….34-35

3.5.4 Testosterone………………………………………………………………………36-37

3.5.5 Progesterone………………………………………………………………………38-39

3.5.6 Estradiol (E2)……………………………………………………………………..40-41

3.5.7 Thyroid Stimulating Hormone………………………………………………42-43

3.5.8 Statistical Analysis…………………………………………………………………..43

Chapter Four…………………………………………………………………………41

4.0 Results…………………………………………………………………………………………….41

4.1 Results of Ovarian Reserve Status in unmarried

female participants based on FSH values of day

3-4 of menstrual cycle.………………………………………….………………………….41

4.2 Results of frequency distribution of unmarried and married

participants using their ovarian reserve function and ovulatory

status. ………………………………………………………………..………………………….43

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4.3 Results of hormonal profiles of unmarried and married female

participants of reproductive age grouped based on

day 3-4 of menstrual cycle…………………………….……..…..………………………45

4.4 Results of hormonal profiles of unmarried and married female

participants of reproductive age grouped based on day 21-23

of menstrual cycle.……………………………………………………………………………47

4.5 Comparison of hormonal profiles between days 3-4 and 21-

23 menstrual cycles of unmarried female participants of reproductive age

…………………………………………………………………………………………………..….49

4.6 Comparison of hormonal profiles between days 3-4 and 21-23

of menstrual cycle of married female control participants

of reproductive age…………………………………………………………….…………….51

4.7 Levels of association between parameters in unmarried

females of reproductive age……….........................................................53

4.8 Comparing hormonal profiles of unmarried female

participants with that of married controls based on

day 3-4 of menstrual cycle….………………..…………………………………………..55

4.9 Comparing hormonal profiles of unmarried female

participants with that of married controls based

on day 21-23 of menstrual cycle ……………………………………………………….57

4.10 Comparing hormonal profiles of unmarried female

participants with that of married controls based on

progesterone values of day 3-4 of menstrual cycle….……………………….…59

4.11 Comparing hormonal profiles of unmarried female

participants with that of married controls based on

progesterone values of day 21-23 of menstrual cycle ….………………………61

Chapter Five………………………………………………………………………….63

5.0 Discussion, Conclusion and Recommendation

9

Discussion…………………………………………………………………………………..63-69

Conclusion…………………………………………………………………………………..69-70

Recommendation……………………………………………………………………………..70

References………………………………………………………………………………..........71-79

Appendix…………………………………………………………………………………………..80-84

List of Tables

Table 4.1: Ovarian reserve status in unmarried female

participants based on FSH values of day 3-4 of

menstrual Cycle……………………………………………………………………..42

Table 4.2: Distribution of unmarried and married participants

using their ovarian reserve function and ovulatory

status based on day 21-23 progesterone ………………………………….44

Table 4.3: Mean±SD of hormonal profiles of unmarried and

married female participants of reproductive age

grouped based on day 3-4 of menstrual cycle ……..……………………46

Table 4.4: Mean(±SD) of hormonal profiles of unmarried and married

female participants of reproductive age grouped

based on day 21-23 menstrual cycle ………………………………………..….48

Table 4.5: Comparison of Mean +SD of hormonal Profiles

Between Days 3-4 and 21-23 of menstrual cycles of

unmarried female participants of reproductive age…….……………..50

Table 4.6: Mean +SD of

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