Anemia in Infertility: A Prospective Study on Prevalence, Morphology, and Reproductive Outcomes

Background: Infertility has become an emerging public health concern in India, impacting a rising proportion of reproductive-aged couples. Anemia, a widespread yet often neglected condition among women, may adversely affect reproductive potential. However, limited data exist on its prevalence and impact among urban Indian women undergoing infertility evaluation. This study aimed to determine the prevalence and morphological patterns of anemia and explore their association with conception outcomes in this population. Materials and Methods: This prospective cohort study was conducted over 18 months and included 107 women presenting with infertility. All participants underwent a standardized infertility workup following established clinical guidelines. Based on hemoglobin (Hb) values, women were categorized as anemic (Hb <12 g/dL) or nonanemic. Anemic participants received oral supplementation with iron, folate, and vitamin B12 for three months. A hemoglobin rise of ≥2 g/dL was defined as a treatment response. Clinical, hematological, and conception outcome data were recorded and monitored over a six-month follow-up period. Results: Anemia was detected in 42% of women, with microcytic hypochromic (51%) and normocytic normochromic (47%) patterns being the predominant morphological types. At six months, conception occurred in 29% of nonanemic women and 22% of anemic women. Within the anemic group, those with Hb <11 g/dL demonstrated a lower conception rate (14%) compared to women with Hb ≥11 g/dL (38%), although this difference was not statistically significant. Among anemic women, treatment responders showed a higher conception rate (33%) than nonresponders (6%). Conclusion: Anemia is highly prevalent among women seeking infertility care and may adversely influence conception, particularly when severe. Effective correction of anemia appears to enhance reproductive outcomes, underscoring the importance of routine screening and timely management of anemia as an integral component of infertility evaluation in Indian women.