Multifactorial Analysis of Infertility and Women's Health: Evidence from Fertility Clinics in Tamil Nadu, India

Introduction: Infertility is an increasing public health concern in India, affecting approximately 27.5 million couples. Among women, infertility is frequently accompanied by psychosocial stress, societal stigma, and marital conflict, particularly in cultural settings where motherhood is closely linked to feminine identity. Despite technological advances in reproductive medicine, there is limited research examining the combined impact of biological, psychological, and social factors on female infertility and associated health issues. Objectives: This study aims to identify physical, psychological, and relational causes of infertility among women in Tamil Nadu. It also examines the effect of these factors on women's general and mental health. Methods: A purposive sample of 1,200 infertile women aged 18-50 years was selected from fertility centers in Thanjavur and Kumbakonam. Data was collected through structured questionnaires and analyzed using AMOS regression modelling. Fifteen hypotheses were tested to assess relationships among physical health conditions, psychosocial variables, and infertility-related health outcomes. Results: Major physical problems, specifically ovarian cysts (15.2%), thyroid disorders (14.9%), irregular menstruation (10%), and uterine fibroids (8.9%). Significant psychological impacts were observed from couple separation and negative spousal behavior (p < 0.001). Although uterine obstruction, ageing, obesity, and overall health were associated with mental distress, not all showed a direct link to infertility. The model demonstrated good fit indices (CFI = 0.993; RMSEA = 0.035). Conclusion: Infertility in women is a multidimensional issue influenced by physical, psychological, and social factors. Integrating mental health care and relationship counselling into fertility treatment is essential for comprehensive care.