Selective abortion following a prenatal diagnosis of Down syndrome presents complex ethical and religious challenges, particularly within the context of Qatar. Advances in prenatal screening enable early detection of chromosomal conditions, prompting debates grounded in the principles of autonomy and non-maleficence. While autonomy emphasizes the pregnant individual’s right to make informed reproductive choices, it does not provide sufficient moral justification for terminating a fetus granted moral personhood. Arguments based on anticipated familial burden or altered expectations fail to demonstrate that lives affected by Down syndrome lack value. From the perspective of non-maleficence, abortion constitutes significant harm by depriving the fetus of a “future like ours,” and claims of psychological harm rely on speculative judgments shaped by societal discrimination rather than intrinsic suffering. Islamic bioethics and Qatari law further restrict abortion, permitting it only under specific conditions, such as severe fetal anomalies before ensoulment or maternal health risks. These frameworks affirm the sanctity of life and reject disability-based termination. Ultimately, ethical responses should prioritize inclusion, reduce stigma, and strengthen support systems for families, aligning medical practice with principles of justice and the equal dignity of all human lives.

Background: Infertility is a growing reproductive health concern globally and poses substantial social and psychological challenges in low- and middle-income countries, including Bangladesh. Despite increasing demand for infertility services, comprehensive couple-based data describing socio-demographic and clinical profiles of infertile couples in Bangladesh remain limited. Objective: To describe the socio-demographic characteristics, infertility patterns, reproductive history, and clinical profiles of couples seeking infertility care in selected healthcare facilities in Bangladesh. Methods: This facility-based cross-sectional study was conducted from May to December 2024 at three private and semi-specialized infertility care centers in Bangladesh. Married couples presenting with primary or secondary infertility were consecutively enrolled. Data were collected using structured questionnaires and medical record reviews. Socio-demographic variables, infertility characteristics, female and male clinical factors, endocrine conditions, semen parameters, and lifestyle factors were analyzed using descriptive statistics. Results: A total of 362 couples were included. The mean age was 26.9 ± 4.7 years for women and 33.1 ± 5.3 years for men, with most couples residing in urban areas (83.7%). Primary infertility accounted for 51.9% of cases, and secondary infertility for 48.1%, with a median infertility duration of 36 months (IQR: 23–60). Among women with secondary infertility, spontaneous abortion was the most commonly reported prior pregnancy outcome (62.1%). Female factor infertility was identified in 94.2% of women, predominantly polycystic ovary syndrome (75.7%) and hypothyroidism (32.9%). Male factor infertility was identified in 43.3% of men; normozoospermia was observed in 74.0%, while asthenozoospermia was present in 19.0%. Mean body mass index was in the overweight range for both women (25.9 ± 4.6 kg/m²) and men (25.7 ± 3.5 kg/m²). Conclusion: Couples seeking infertility care in Bangladesh commonly present after prolonged infertility and exhibit a high burden of identifiable female and male clinical factors, alongside modifiable lifestyle characteristics. These findings underscore the need for integrated, couple-centered infertility services and timely access to standardized diagnostic and management pathways.