Objectives Female infertility is a global health concern. The association of genital infections with female infertility is neglected due to their chronic but asymptomatic nature. Lack of routine diagnosis and delay in treatment further causes intractable pathological sequalae and consequential infertility. This study aims to identify the most significant prognostic symptoms of genital infection(s) that correlate strongly with reproductive tract anomalies, menstrual disorders, and infertility.

Methods We designed a detailed questionnaire and conducted a cross-sectional study with 100 female subjects, categorized into infertile (n1 = 62) and healthy groups (n2 = 38). The data collected was documented and statistically analyzed.

Results This study highlights an early onset of infertility (21-30 years). Almost 27% of the infertile subjects are symptomatic for genital infections and ∼42% exhibit menstrual irregularities. Polycystic ovarian syndrome/disease (PCOS/PCOD, ∼30%), are observed to be the most predominant disorders followed by endometrial disorders (∼10%) and tubal damage (∼8%) in infertile subjects. A multivariate correlation analysis revealed a highly significant (p ≤ 0.05) and strong association (0.15 < Φ ≤ 1.0) between menstrual disorders, endometrial disorders, uterine/tubal blockage, and hormonal disruption with infection-associated symptoms, such as vaginitis, cervicitis, pelvic inflammatory disorder (PID), dyspareunia, tuberculosis (TB), urinary tract infection (UTI), sperm, and semen abnormalities.

Conclusions Our study reveals genital infections to be a significant contributor to female infertility. The questionnaire designed here offers a useful tool for self or clinical assessment and may help in timely prognosis/diagnosis of genital infections which may contribute to improved management of reproductive health and fertility.

Synopsis The study reveals impact of genital infections on female infertility and offers a comprehensive questionnaire-based tool for an early self/clinical prognosis of infection induced infertility.

The authors have declared no competing interest.

Source of financial support in the form of grants: 1.Indian Council of Medical Research (ICMR), Govt. of India, Senior Research Fellowship (RBMH/FW/2019/13) awarded to Naresh Patnaik (2019-2022). 2.Research Initiation Grant (RIG) and Centre for Human Disease Research (CHDR) programs intramurally funded by Birla Institute of Science and Technology (BITS) Pilani, Hyderabad campus, India to Ruchi Jain Dey (June 2018-March 2023). 3. Ramalingaswami Re-entry fellowship (BT/RLF/Re-entry/18/2016) awarded to Ruchi Jain Dey (May 2018-April 2023).

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The research was conducted in accordance with the ethical guidelines set forth by the Indian Council of Medical Research (ICMR) for biomedical and health research involving human participants. The study was approved by the Institutional Human Ethics Committee (IHEC) of Birla Institute of Technology and Sciences (BITS) Pilani Hyderabad campus (Protocol number: BITS-HYD/IHEC/2022/01). All individuals who participated in the study were fully informed about various aspects, including the study's objectives, methodologies, sources of funding, potential conflicts of interest, institutional affiliations of the researcher, anticipated benefits, potential risks, and the discomfort they might experience. Their participation was contingent on obtaining their informed consent. Furthermore, to safeguard patient confidentiality, we took measures to de-identify patient information. This included the removal of exact ages, which were replaced with age ranges, and the omission of exact dates or photographs during presentation of the data.

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All data that supports the findings of this study are available from the corresponding author upon reasonable request.