African Journal for Infertility and Assisted Conception

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Background: Infertility has grown to be a major health and social challenge in our environment that a childless marriage is regarded as a failed marriage. Couples are therefore ready to do all within their power to achieve pregnancy and have a baby of their own. This is the yawning gap assisted reproductive technology is fulfilling. Objective: To determine the outcome of in vitro fertilization (IVF) procedures 2 years after the commencement of the IVF program in a private hospital setting in Nnewi, Nigeria. Methods: From October 1, 2010 to September 30, 2012, 115 couples had conventional IVF procedures in batches of 10-15 couples. The outcome measures were clinical pregnancy rate, miscarriage rate, live birth rate, and sex ratio following one or two cycles of treatment. The results were analyzed using Epi info software 2013 version 7.0. Results: The mean age of the participants was 43.7 ± 3.5 years. The maximum number of embryos transferred per woman was four and minimum was one. The rates of clinical pregnancy, live births and multiple pregnancies were 30%, 18.3%, and 6.0%, respectively. Of the 31 women who conceived, 21 (67.7%) delivered live infants and 10 (32.3%) aborted in the first trimester. There was no case of ectopic pregnancy. The male:female sex ratio was 2:1. The mean endometrial thickness at embryo transfer (ET) was 8.9 ± 2.3 mm. Conclusion: The success rate of IVF-ET was good even in low resource settings and optimal endometrial thickness prior to ET may be one of the key success factors. The preponderance of male sex infants in our IVF births is acceptable to the couples who ordinarily have a preference for male infant.

Background: Male factor infertility is a global health issue that requires further studies to understand its magnitude, especially in developing countries, where the woman is usually blamed for the couple's infertility. Objectives: This study aimed to determine the patterns of male infertility in a teaching hospital in Ghana. Methodology: This was a prospective study of 110 male patients who presented with infertility at the urology outpatient clinic of the Komfo Anokye Teaching Hospital, Kumasi, Ghana, from January 1, 2014, to December 31, 2017. Results: One hundred and ten men reported for the treatment of infertility over the study period. The mean age was 38.5 ± 7.4 years. The majority (58.2%) had primary infertility while the remaining 41.8% had secondary infertility. Four (3.6%) of the men had unilateral or bilateral cryptorchidism while 41 (38.7%) of those with both testes resident in the scrotum had small-sized testes. Varicoceles were present in 24 (22.6%) men, 58.3% of whom had primary infertility while the remaining 41.7% had secondary infertility. Thirty-eight (34.5%) of patients had low semen volume was seen in 38 (34.5%) patients. Azoospermia was seen in 28 (25.5%) patients with 30 (27.3%) patients having no motile spermatozoa. Conclusion: Male infertility in Ghana should receive more recognition, and male participation in reproductive health programs should be encouraged.

The challenges associated with infertility have necessitated different healthcare-seeking behaviors ranging from spiritual, traditional/alternative health care to orthodox medical types including biotechnological devices such as assisted reproductive technology (ART). ART is the highest breakthrough in the medical treatment of infertility in the whole world. Its evolution has presented multitudinous ethical, legal, and social challenges resulting in a tectonic shift in the way clinicians and the general population perceive infertility and ethics. Hence, there is a urgent need for stakeholders (fertility specialists, clients, professional organizations, religious bodies, bioethicists, and government) to formulate cultural and context-specific guidelines to help address some of these ethical dilemmas.

Background: Seminal fluid analysis (SFA) is the most important investigation of the infertile males but limited in revealing the etiologies of the various spermatozoa abnormalities observed on microscopy. Increasing prevalence of male infertility and the challenges of diagnosis require biochemical investigations such as reproductive hormonal profile. Aims: The aim of this study is to determine the reproductive hormonal profile patterns among infertile males in Ilorin. Settings and Design: This was a descriptive, cross-sectional study. Materials and Methods: A total of 130 male partners of infertile couples served as subjects and 50 fertile males as controls. Serum reproductive hormonal assay was done using ELISA method. Statistical Analysis Used: Statistical Package for the Social Sciences (SPSS) version 20.0 (SPSS Inc., Chicago, IL, USA) was used. Normally distributed data were expressed as mean ± standard deviation. Results: The mean age of the subjects who were majorly civil servants was 38.6 ± 6.6 years. The prevalence of reproductive endocrinopathies in this study was 46.9%. Mean serum concentrations of follicle-stimulating hormone, luteinizing hormone, and prolactin were elevated in our subjects than control. Mean serum testosterone concentration was significantly lower in our infertile subjects. Patterns of hormonal profile abnormalities among our subjects were 2 (1.5%) with hypogonadotropic hypogonadism, 15 (11.5%) with hypergonadotropic hypogonadism, 23 (17.7%) with hypergonadotropic normogonadism, 21 (16.2%) with normogonadotropic hypogonadism, and 69 (53.1%) with normogonadotropic normogonadism. This showed 59 (45.4%) subjects with primary testicular failure/resistance and 2 (1.5%) with secondary testicular failure. Twenty (15.4%) of the subjects had hyperprolactinemia. Conclusions: Reproductive hormonal profiling of male partners of infertile couples is an important adjuvant to SFA, in diagnosis and monitoring responses to treatment.

Online since 12^th Aug, 2016