Correlation of female age with outcome of IVF in a low-resource setting.

OBJECTIVE: To determine the effect of female age on pregnancy outcome after in vitro fertilization/embryo transfer (IVF-ET). METHODS: A prospective study was conducted involving 266 women who had IVF-ET at Nisa Fertility and Genetic Center, Abuja, Nigeria. All eligible consenting women were recruited to the study. The main outcome measure was clinical pregnancy. Data were analyzed using IBM SPSS Statistics version 25. P < 0.05 at 95% confidence intervals was taken as significant. RESULTS: A total of 266 patients were recruited and included in the study; 104 pregnancies were recorded, giving an overall pregnancy rate of 39.1%. The age range of the patient was 26-43 years (mean age 33.9 ± 2.41 years) while the mean number of embryo transfers per patient was 2.2. The clinical pregnancy rate for women aged below 30 years was 69.4% while the pregnancy rate for patients aged 30-34 years, 35-39 years, and 40-43 years was 52.6%, 24.7%, and 9.4%, respectively (P < 0.0001). CONCLUSION: The study found that the success rate of IVF-ET decreases significantly in women aged over 34 years. Women should be counseled about the age-related risk of infertility and referred to a fertility center as early as possible.

Female sterilization by tubal ligation: a re-appraisal of factors influencing decision making in a tropical setting.

BACKGROUND: Female sterilization by tubal ligation is the most commonly used method of fertility regulation. However, in some lesser-developed countries like Nigeria, it has not been accepted as a popular method of contraception. OBJECTIVE: To assess the pattern of female sterilization and determine factors that may influence its acceptability. METHOD: A retrospective study of 102 cases of tubal ligation (TL) performed between January 1999 and December 2004. RESULT: Of the 102 patients/clients, 60 (58.8%) had TL at caesarean section, 28 (27.5%) had TL with repair of ruptured uterus and 14 (13.7%) clients had TL alone on request. In the reproductive age group, the rate of TL increased with age. In the group that had TL at caesarean section, the highest incidence of TL (65%) was recorded against parity 4. However, in the groups that had TL with repair of ruptured uterus and TL alone, the highest proportion of TL was recorded against parity 6, with rates of 46.3 and 57.1%, respectively. The rates of TL increased with the level of literacy. In the group that had TL alone, 92.9% of the clients were in a monogamous union. On the contrary, 89.3% of patients that had TL with repair of uterine rupture were in a polygamous union. There was relative distribution of patients/clients amongst the two religions and five ethnic grouping. In 55 of the 102 patients/clients, the indication for TL was completion of family size, though 41 of the 55 patients had TL at caesarean section. CONCLUSION: Demand for TL alone was low. A greater percentage of the patients had TL in conjunction with another surgical procedure.

An analysis of surgically managed cases of pelvic abscess complicating unsafe abortion.

BACKGROUND: This study was carried out to study the demographic variables, treatment options and mortality in cases of abortion related pelvic abscess. METHODS: A retrospective study of patients that had pelvic abscess as a complication of unsafe abortion. The retrieved case files were scrutinized for the necessary information. RESULT: The age ranged from thirteen years to forty six years, and teenagers accounted for 24.3% of the patients. About half of the patients, 51.4% were childless and parity ranged from zero to eight. The abortionists were mainly untrained personnel and the contraceptive prevalence rate was low, 5.4%. Most of the patient had conservative surgery and a significant number 94.6%, had blood transfusion. Maternal death of 18.9% was recorded with infection being the major cause. CONCLUSION: Unsafe abortion and its attendant complication is still a problem in Nigeria. High quality post abortion care will help a long way in saving many lives.