Background: Out of all the human beings present the 20% are infertile. The 10-15 couple experience difficulties in conceiving. Study design: It is a cross-sectional study with statistical approach, conducted at Department of Obstetrics and Gynaecology, Indus Hospital Jubliee Town, Lahore. Objective: The study aimed to study the psychological effects of subfertility on women. Material and Methods: The study was conducted on the 80 female patients under treatment as they are not conceiving after repeated unsuccessful attempts. The female attended the gynecology department of our institute teaching hospital. The review board of the hospital approved the study. The average duration of not getting pregnant was 2 years in these participants. The study was conducted for 6 month from January 2022 to June 2022. Results: The average duration of not getting pregnant was 2 years in these participants. Most of the women reported that they previously had no child. However, there were 14% of them that had one child already. The mean of the state anxiety in these female participants came out to be 44 with a SD of 9.5. And the trait anxiety was reported to be 41 with SD of 7.1. Both of these features were found to be higher in case of sub fertile female patients undergoing fertility treatment. The level of stress was shown to be high in case of marital issues as compare to the social stress and personal stress. The educational level was found to be statistically linked to the participant’s stress level. However, the financial condition and age was not found to be linked to stress in sub fertile female. Conclusion: The women undergoing fertility treatments as they are not being successful to conceive suffers from stress, anxiety and depression like psychological issues. The societal pressure and low educational level are some of the factors that elevates the psychological issues in sub fertile female. If proper professional guidance is given to the patients it can help them cope with the fertility issue stress free. Therefore, counseling is a much helpful thing to accept and face the challenges of sub fertility. Keywords: Subfertility, psychological status, stress, anxiety and education level

Objective: The objective of this study was to evaluate frequency of tubal factors as a cause of female subfertility using laparoscopy. Study design: It was a cross-sectional study Setting: This study was conducted at Obstetrics and Gynecology department, Arif Memorial Teaching Hospital Lahore / Rashid Latif Medical College Duration of study: Study was done in 6 months [June 4, 2022 till December 4, 2022] Methodology: Using non probability consecutive sampling 179 females with primary and secondary subfertility who fulfilled the inclusion and exclusion criteria were enrolled in the study. Detailed demographics were recorded after taking informed written consent. Results: The mean age of participants was 29.12 ± 4.04 years with minimum and maximum age between 19 and 42 years. The mean duration of marriage was 7.13 ± 3.66 years with minimum and maximum duration of marriage between 3 and 17 years. The mean duration of subfertility was 5.32 ± 3.26 years with minimum and maximum duration of subfertility between 2 and 18 years. There were 137(76.5%) of the cases who had primary and 42(23.5%) females had secondary subfertility. A total of 56(31.2%) females had tubal factors and 123(68.7%) females did not have tubal factors as cause of subfertility. There were 39(21.8%) females who had Peri tubal adhesion, 17(9.5%) females had tubo ovarian mass. Among the 56 participants who had tubal factor presents 40 (22.3%) had bilateral blocked tubes Conclusion: Through the findings of this study , we concluded that 31.2% females had tubal factors subfertility, including 21.8% females with peri tubal adhesion and 9.5% females with tubo ovarian mass. 22.3% of the participants had bilateral blocked tubes. Hence proper evaluation of the female partner in a subfertile couple should be done by laparoscopy which is a superior tool for diagnosing tubal factors responsible for subfertility and tubal patency should also be confirmed before prescribing treatment such as ovulation induction. Keywords: Infertility, diagnostic laparoscopy, tubal factors, peri tubal adhesion, tubo ovarian mass, blocked tubes