Facteurs associés à l'infertilité féminine liée aux adhérences à Mbujimayi (RDC) / Factors associated with female infertility due to adherences in Mbujimayi (DRC)

Dans une société pro-nataliste, l'infertilité féminine est considérée comme un drame. Cette étude avait pour objectif d'identifier les facteurs associés à l'infertilité mécanique féminine liée aux adhérences pelviennes à Mbujimayi. MéthodologieIl s'agissait d'une étude cas-témoins, réalisée dans les Hôpitaux Généraux de Référence Dipumba et Saint Sauveur à Mbujimayi (RDC), durant une période allant du premier janvier 2006 au 31 décembre 2020. Nous avons colligé un total de 354 cas RésultatsLes facteurs associés à l'infertilité mécanique féminine étaient: l'âge inférieur à 20 ans qui multipliait par 4 le risque de développer des adhérences pelviennes (OR=4,01[1,19-13,49]); l'antécédent des infections sexuellement transmises (IST) (OR=1,77[1,06-2,96]) et l'antécédent de chirurgie abdomino-pelvienne (OR=1,76[1,07-2,88] qui multipliaient respectivement de presque par 2 le risque d'avoir les adhérences pelviennes. Ces associations étaient statistiquement significatives. ConclusionLes IST et la chirurgie abdomino-pelvienne exposent au développement des adhérences pelviennes et/ou aux altérations tubaires conduisant à l'infertilité féminine. Leur prévention doit se baser sur la prise en charge préventive des IST par la sensibilisation pour une sexualité responsable surtout chez les adolescentes, la rationalisation dans les indications et la bonne pratique de la chirurgie abdomino-pelvienne par les médecins.

Introduction: In a pro-natalist society, female infertility is considered a tragedy. This study aimed to identify the factors associated with female mechanical infertility related to pelvic adhesions in Mbujimayi. Methodology This was a case-control study, carried out in Dipumba and Saint Sauveur General Reference Hospitals in Mbujimayi (DRC), during a period from January 1, 2006 until December 31, 2020. We collected a total of 354 cases ResultsThe factors associated with female mechanical infertility were: age below 20 years, which multiplied by 4 the risk of developing pelvic adhesions (OR=4.01 [1.19-13.49]); history of sexually transmitted infections (STI) (OR=1.77[1.06-2.96]) and history of abdomino-pelvic surgery (OR=1.76[1.07-2.88] which respectively increased the risk of having pelvic adhesions by almost 2. These associations were statistically significant. Conclusion: Sexually transmitted infections (STI) and abdomino-pelvic surgery expose the patient to the development of pelvic adhesions and/or tubal alterations leading to female infertility. Their prevention must be based on the preventive management of STI by raising awareness for responsible sexuality, especially among adolescents, the rationalization of the indications and the good practice of abdomino-pelvic surgery by doctors

Sexual Experiences of Infertile Women: A Qualitative Study

It is suggested that stress related to infertility causes marriage conflicts and decreases in the frequency of sexual intercourse. Aim: This study aimed to explore the experiences of the sexuality of infertile women. Patients and Methods: A phenomenological design was used in this study. We conducted face-to-face, semistructured, in-depth interviews with 11 infertile women. The interviews were audio-recorded, and a thematic approach was used to assess the data. Results: The average age of the women was 33.05 ± 3.40 years, and their age of first sexual intercourse was 23.0 ± 2.8 years and all of them are legally married. The durations of experiencing the problem of infertility were as follows; 3-5 years in 33%, 6-10 years in 27%, and 11 years and above in 38%. According to interpretative phenomenological analysis, two main themes emerge. Two main themes were determined: Perception of Sexuality and Sexual Problems. The results show that infertile women have a higher risk for sexual dysfunction than fertile women. Conclusion: These findings suggest that the diagnosis of infertility is an important factor in assessing the differences in the sexual satisfaction of women. In infertility counseling, health professionals must explain the gender differences. Also, infertile couples must encourage to share each other's feelings and this may help couples to cope with the communication problems they may experience.

'Gift with a price tag': Nigerian egg donors' knowledge, experiences and motivations

Research around the world has indicated that the demand for egg donation has grown considerably among young females. This study qualitatively examines the knowledge, experiences, and motivations of young egg donors at a Nigerian health facility. Indepth interviews were conducted in Igbo and English with consenting thirty-one egg donors attending a fertility clinic in Anambra State, south-eastern Nigeria. Data were collected and analysed to generate themes with the aid of NVivo 10 software. Three themes were identified from the participants' motivations and include (a) monetary (93.6%), (b) altruistic (3.2%), and (c) both monetary and altruistic reasons (3.2%). Findings highlighted that the differences were based on a variety of reasons in Nigeria. All the participants were literate and single, and the majority received payment. The majority (77.4%) of those who received payment mentioned that the payment was not worth the donation program. The participants preferred to be anonymous because they had not discussed their donation with their family members, and the non-acceptance of egg donation program by the Nigerian society. Given that the market for egg donation has become a common method of infertility management in Nigeria, our findings have important implications for practices, policy actions, and future research. (Afr J Reprod Health 2022; 26[6]:64-79).

A qualitative synthesis of the impact of infertility on the mental health of African women

Infertility is a reproductive problem that affects all gender, race, or social class. In many African countries, the burden of infertility is usually associated with economic, psychological, and socio-cultural factors. This review aimed to explore the factors that impact the mental health of African women with primary infertility. A qualitative evidence synthesis was used to summarise and analyse primary qualitative studies focused on the impact of primary infertility on African women. Seventeen studies met the eligibility criteria and were included in the review. The review found that social pressure, stigma from family and community members, and financial constraints led to psychological distress. In addition, social stigma also led to marital problems which led to significant psychological distress and low self-worth, especially on the wife. Recommendations to reduce stigma among African infertile women were as follows: advocacy and community mobilisation, education by health professionals, and holistic person-centred care. An intersectional approach to inform public health and social policy was also suggested.

Comparative analysis of psychiatric morbidity of women with infertility and those attending family planning clinic in a tertiary facility in north-east Nigeria

Background: Infertility is a major life crisis often associated with mental health consequences. It is particularly relevant in African setting including Nigeria where women are largely blamed for the cause of infertility with its attendant shame, guilt, anxiety and hopelessness. Objective: The aim of this comparative study was to assess and compare psychiatric morbidity of women with infertility and those who attend family planning clinic. Methodology: This descriptive cross-sectional study was done using consecutive sampling technique to select 400 women in each group of those attending fertility and family planning clinics. Data were collected using semi-structured socio-demographic questionnaire, self-administered General Health Questionnaire-12 and Hamilton Depression and Anxiety Scale after matching the groups by their age, marital status and years of education. Results: The study found 37.6% of those who attend fertility clinic to have met HADS cut off score for depression as against 6.8% of the family planning clinic attendees. Similarly, for anxiety subscale; a high proportion of infertile group (40.3%) met anxiety cut off compared to those who attend family planning clinic. In the same manner, attendees of the fertility clinic significantly experienced high rate of psychiatric morbidity (52.9) on the GHQ compared to those attending family planning clinic (32%). Conclusions: This study revealed that Nigerian infertile women seeking treatment are exposed to several mental health consequences such as anxiety and Depression amongst others with devastating effects on the mental health and well-being of the infertile women. Consequently, a comprehensive biopsychosocial intervention should be integrated into the overall management of infertility to improve their quality of life and chances of conception

The quality of life and dyadic adjustment of couples receiving infertility treatment

The aim of this study was to determine the factors that affect the dyadic adjustment and quality of life of individuals receiving infertility treatment and to evaluate the effect of dyadic adjustment on their quality of life. This study was conducted as a descriptive and cross-sectional study with 209 males and 213 females. The study data was collected using an introductory information form about socio-demographic characteristics, the Dyadic Adjustment Scale and the FertiQol Scale. The main findings of the study were that gender and marital status influenced dyadic adjustment and quality of life (p<0.05), and that income status affected only dyadic adjustment (p<0.05). There was a statistically significant relationship (37%) between scores for dyadic adjustment and scores for quality of life (p<0.001). It was determined that females in infertility treatment had lower dyadic adjustment and quality of life than men

Assessment of the prevalence of abnormal hysteroscopic findings in infertile women undergoing ART

Background: The endometrium plays an important role in implantation of good quality embryos in ART. Many studies have proved the negative impact of intra uterine pathologies on reproductive outcome whether spontaneous pregnancy or ART, because uterine anomalies may be associated with many obstetric complications such as miscarriage, preterm birth, premature rupture of membrane, malpresentation, postpartum bleeding and retained placenta. Aim of the work: This study aims to assess the prevalence of abnormal hysteroscopic findings among infertile women undergoing ART at Ain Shams Maternity University Hospital over the period from January 2007 to January 2017. Patients and Methods: This descriptive retrospective study was carried out on infertile couples planned for ART who were sent to ECDU for hysteroscopy in Early Cancer Detection Unit (ECDU), Ain Shams University Maternity Hospital. Case reports From January 2007 to January 2017 were reviewed. Results: The most prevalent congenital abnormality was endometrial polyp (18.4%) followed by uterine septum (6.9%). Conclusion: This study concluded that the most common uterine abnormality was endometrial polyp (18.4%), followed by uterine septum in 6.9% of patients. Also, thick endometrium was very common with a prevalence of 12.9%. Therefore, based on this high prevalence of abnormalities, this study is in agreement with the opinion that all women should be offered hysteroscopy, even if they have normal vaginal ultrasound and hysterosalpingography, because this is supposed to increase the detection rate of minor abnormalities, which theoretically will improve the reproductive outcome. Still, further interventional randomized controlled trials (RCT) are needed to verify the positive impact of routine use of hysteroscopy prior to ART

Depression among infertile women in Ogbomosoland

Background: Infertility is a major medical condition that affects many married couples globally and it has immense psycho-social impact on couples, especially in Africa where a high premium is placed on child-bearing. This study therefore determined the prevalence of and the factors associated with depression among infertile women in Ogbomoso, Southwest Nigeria.Methods: The study was a descriptive cross-sectional study carried out at the gynaecology clinic of the Bowen University Teaching Hospital using the Patient Health Questionnaire-9 to screen for and determine the severity of depression as well as assess the social functioning of the respondents. A total of 110 women with infertility were recruited. Data was analysed using SPSS® (version 20) with statistical significance set at less than 0.05.Results: The study found a depression prevalence of 52.7%. There was no significant association between the age group of the respondents (p = 0.889), their level of education (p = 0.731), years since marriage (p = 0.38), type of infertility (p = 0.873), number of living children (p = 0.226), sex of the children (p = 0.257) and depression. Depression was, however, significantly associated with impairment in social functioning of the respondents (p = 0.005).Conclusion: Depression is a very common co-morbidity in infertile women. It should not only be screened for among infertile women, but physicians attending to such women need to offer psycho-social support as part of care for these women

Prévalence et profil des coules pris en charge pour infertilité du couple à l'Hôpital de la Mère et de l'enfant de N'Djamena

Introduction: L'infertilité est une pathologie fréquente dans les pays en développement et pose un problème de prise en charge. L'objectif était de déterminer sa prévalence et le profil des couples consultant pour infertilité dans de la Mère et de l'enfant de N'Djamena. Méthodologie:Nous avons mené une étude transversaledescriptive portant les couples ayant consulté pour infertilitédu 1er Décembre 2014 au 30 Novembre 2015. Tous les couples vus pour infertilité ayant effectué tous les bilans et ayant accepté de participer à l'étude après un consentement éclairéont été inclus. Résultats: La prévalence de l'infertilité était de 14%. Cette infertilité était de prédominance secondaire(61%). La majorité des couples dans cette série avait une infertilité d'une durée d'un à trois ans (67,9%). Les tranches d'âges les plus touchées étaient celles de 30 à 34 ans avec un âge moyen de 28,9 ans ± 6,1 chez les femmes et de 40 ans et plus et 30 à 34 ans et 25-29 ans avec un âge moyen de 34,1 ans ± 6,7 chez les hommes. Le statut matrimonial était dominé parles monogames (60,7%). L'infertilité était féminine dans 42% des cas, masculine dans 30% des cas et mixte dans 28% des cas. Les anomalies de spermogramme étaient présentes chez 50% des couples, les infections dans 48,2%, les troubles hormonaux dans 39,3% et les obstructions tubaires dans 23,2%. Conclusion: L'infertilitéest un réel problème dans nos milieux dont la responsabilité incombe également aux 2 sexes. Cela devrait être pris en compte dans la prise en charge

Pratique de l'hysterosalpingographie a l'hopital regional de Ngaoundere

OBJECTIFS:Decrire la pratique et les resultats de l'HSG dans le Service d'Imagerie Medicale de l'Hopital regional de N'Gaoundere.MeTHODES: Il s'agit d'une etude transversale descriptive. Les donnees ont ete collectees de janvier a decembre 2012 au travers d'un questionnaire. Les 120 hysterosalpingographies effectuees durant la periode d'etude ont ete incluses. Elles representaient 72;8 des examens radiologiques specialises et 3 de toutes les radiographies. L'age moyen des patientes etait de 33 ans. Les patientes avec une gestite de 0 a 1 representaient 80;5 et celles avec une parite de 0 a 1 representaient 90. Les antecedents etaient domines par les infections genitales (75); puis les avortements spontanes (10) et les avortements provoques (8). ReSULTATS L'indication principale de l'HSG etait l'infertilite (67;50); suivie du bilan tubaire apres myomectomie (16;90); des avortements a repetition (5;83); de la pelvialgie chronique (5) et des metrorragies (5). Le produit de contraste utilise etait iode hydrosoluble; et le volume moyen administre etait de 22 ml. En moyenne; six cliches ont ete realises par patiente. Dans 65;83 aucun effet indesirable n'a ete observe. Les effets indesirables observes etaient la douleur (26;3); l'hemorragie (5;30) et le malaise vagal (2;6). 89;47 des HSG avaient une lesion. Les pathologies observees etaient les obstructions tubaires (36; 66); les malformations uterines (12;5); les hydrosalpinx (8;35); les suspicions de myome (6;70); les beances du col (5;83); les synechies uterines (5;83) et les adherences peritoneales (5;83). CONCLUSION L'HSG est l'examen radiologique specialise le plus pratique dans le bilan de l'infertilite feminine a Ngaoundere. Ses resultats sont comparables aux autres series africaines. La douleur est le principal effet indesirable

Profil clinique et étiologique de l'infertilité féminine à Goma

Objectif : Une etude visant a degager le profil epidemiologique; clinique et etiologique de l'infertilite chez la femme a ete menee a Goma/RDC et ses environs; de janvier 2006 a decembre 2008.Methodologie : il s'agit d'une etude cas-temoins comparant les femmes consultant pour infertilite et les femmes fertiles (gestantes); au regard des parametres sociodemographiques; medicaux; sexuels; gynecoobstetricaux; chirurgicaux; et cliniques. Les patientes infertiles ont beneficie; en plus de l'examen gynecologique approfondi; d'une exploration systematique par l'HSG; les dosages hormonaux; l'echographie endovaginale et pelvienne. Le chi carre de Pearson ou le test de rapport de vraisemblance; et le test t de Student ont ete mis a profit pour l'analyse statistique des donnees.); de loin le plus preponderant; etait suivi par des troubles ovulatoires (41;0); les facteurs uterin et cervicovaginal etaient relativement moins frequents. L'etiologie etait multifactorielle dans 38;1 des cas. La preponderance du facteur tuboovarien suggere une grande implication des infections genitales dans la survenue de l'infertilite feminine a Goma. Resultats : 105 femmes infertiles et 108 gestantes ont ete examinees en series continues. Les patientes fertiles sont significativement plus jeunes que les patients infertiles (p=0;001). Bien que l'age au debut de l'activite sexuelle ne soit pas different entre les patientes et les gestantes (p=0;67); les patientes infertiles etaient caracterisees par une plus grande mobilite conjugale (p=0;015) et sexuelle (p=0;001); une plus grande frequence des antecedents d'infections genitales (p=0;00) et des interventions chirurgicales pelviennes; et par des symptomes suggestifs des sequelles d'infections genitales. Les facteurs etiologiques suivants ont ete identifies : le facteur tubopelvien (67;6

Knowledge and attitudes toward child adoption and fostering among infertile women in northern Nigeria

Background: Infertility is a public health problem in the developing countries. However, the role of child adoption or fostering in the management of infertile couples is underexplored, particularly in northern Nigeria. Materials and Methods: A cross-sectional study involving the use of a structured interview questionnaire was employed to collect information from clients attending the infertility clinic of Aminu Kano University Teaching Hospital (AKTH), Kano. The data were analyzed using MINITAB® 12.21 software. Percentages and means were used to describe categorical and quantitative variables, respectively. The chi-square test was used to assess the significance of associations using a confidence interval of 95%. Results: Majority of the respondents (69.7%) were between 25 and 34 years of age, and of Hausa/Fulani ethnic group (79.6%). Knowledge of child adoption was good in 59.2% of the respondents, while the willingness to adopt versus foster was 28.2% and 44.4%, respectively. Conclusion: There is a need to advocate for infertility counseling services, so as to support infertile clients in taking informed decisions regarding child adoption or fostering as viable options for having their own families

L'echographie doppler couleur scrotale dans la recherche etiologique de l'infertilite conjugale

Introduction : l'infertilite masculine est de plus en plus importante(1). Les etiologies sont variees; l'echographie doppler couleur des bourses constitue l'examen d'imagerie de premiere intention dans la recherche etiologique. Le but de notre travail est d'evaluer la place de l'echographie doppler couleur dans l'exploration de l'infertilite masculine. Patients et methodes : Nous avons realise une etude retrospective sur une annee de 53 dossiers de patients ayant consulte pour infertilite du couple. Une echographie doppler couleur des bourses a ete realisee pour tous les patients. Elle a permis de noter pour chaque patient la taille; le volume; les contours du testicule et l'aspect du cordon. Le doppler couleur precisait la cartographie vasculaire. Resultats : la moyenne d'age etait de 39;5 ans; la duree moyenne d'infertilite etait de 07 ans et demi. L'examen clinique avait retrouve 20 cas de varicocele clinique dont 12 gauches et 8 bilaterales. L'echographie Doppler couleur avait retrouve 42 cas de varicocele dont 11 confirmant l'examen clinique (3 varicoceles gauches et 8 varicoceles bilaterales); et 31 infra cliniques avec 13 cas de varicoceles bilaterales; 12 cas de varicoceles droites et 6 cas de varicoceles gauches. Les valeurs du diametre des veines droites et gauches variaient entre 2 et 4;8 mm; un reflux a ete objective chez tous nos patients. 33 patients avaient une atrophie testiculaire droite; 35 patients une atrophie testiculaire gauche. 2 cas de kyste para-epididymaire; 3 cas de micro lithiases testiculaires; deux cas d'hydrocele ont ete retrouves. L'echographie Doppler couleur etait normale chez 3 patients. Conclusion : Cet examen est une methode d'imagerie de premier choix dans la strategie diagnostique de l'infertilite masculine