International Journal of Medical and Health Research

Authors
Osaikhuwuomwan James A, Osemwenkha Abieyuwa P

Abstract
Background: The prevalence and pattern of infertility vary between countries and regions. This study aims to determine the current pattern and major causes of infertility as seen in a dedicated fertility clinic with assisted reproductive technology services in sub-Saharan Africa. Method: This was a prospective observational study that included all patients accessing infertility treatment at the infertility clinic of the Hospital over a 30 month period. Infertile couples were fully investigated according to the World Health Organization guideline. Results: Four hundred and five infertile couples formed the subject of this study. The mean age was 38.1±5.9 and 43.3±7.4 for female and male partners respectively. The duration of infertility ranged from 1 to 26 years with a mean duration of 8.0 ± 4.9 years. Of the 405 couples, 88 (21.7%) had primary infertility and 317 (78.3%) had secondary infertility. In comparison, male factors alone independently contributed more to the aetiology of infertility than female factors alone [121 (29.9%) vs 113 (27.9%)] though this was not statistically significant (p > 0.05). Overall, combined female and male aetiological factors accounted for most cases of infertility 161 (39.6%). 2.5% (10) had unexplained infertility. Majority of those with female factor infertility had tubal occlusion (94; 34.3%), while for the male partners, a majority 114(40.4%) had a combination of semen abnormality; oligo-astheno-teratozoospermia. There was a significant association between male factor infertility and primary type infertility, p< 0.05. Conclusion: Secondary infertility is still dominant in our environment. Also, male factor infertility is increasingly common and contributes significantly to primary infertility. Treatment approach should emphasize the couple rather than the woman alone.