Exploring the psycho-social burden of infertility: Perspectives of infertile couples in Cape Coast, Ghana.

Infertility is a complex and often sensitive issue with far-reaching psycho-social ramifications for couples and their families. This study therefore seeks to delve into the psycho-social burden of infertility in Cape Coast, a major city in Ghana. Specifically, we explored the impact of infertility on the psychological and social health of infertile couples receiving fertility treatment. It also delves into the strategies they adopt to cope with their conditions. The study employs a qualitative approach to inquiry using phenomenology as a study design to explore the experiences of the study participants. In-depth interviews were conducted using interview guides, voice recorded and transcribed verbatim. Both inductive and deductive/framework coding techniques were used to code the data leading to the generation of themes and sub-themes. The results show that most of the study participants dealing with infertility faced psychological burdens from different sources including their families, society and themselves. These burdens take a toll on their mental health, pushing them into a state of desperation and depression. It was, however, revealed that infertile couples are able to cope with the help of their family, spouses and the church. Curiously, some of them opt for withdrawal from social events as a coping mechanism. Infertility exerts an enormous negative psycho-social impact on affected couples, especially women. The family and society serve as the main sources of stressors for infertile couples. Therefore, programmes that are aimed at fertility treatment should deliberately consider addressing the psychosocial burden of infertility through education targeting actors, especially interpersonal-level actors.

Pharmacotherapy for Infertility in Ghana: A Prospective Study on Prescription Patterns and Treatment Outcomes among Women undergoing Fertility Treatment.

Background: Pharmacotherapy remains a first-line and major treatment option for couples struggling with infertility, especially in sub-Saharan Africa, where other expensive alternatives are rarely available. Despite the reliance on pharmacotherapy for treating infertility in the subregion, especially for those diagnosed with unexplained infertility, little is known about the actual influence of drug therapies on conception. Objectives: The study aimed to prospectively assess the prescription patterns and outcomes of pharmacotherapy for women undergoing fertility treatment in Ghana. Methods: This prospective cohort study involved 482 infertile women presenting for fertility treatment in 4 fertility clinics in the Cape Coast Metropolis of Ghana between March 2019 and February 2021. A simple random sampling technique was used to recruit subjects for the study. The women were followed up for 12 months to assess the outcome of drug therapy on conception. Data analysis was done using Stata version 14. Logistic regression was used to assess the association between trends with dichotomous outcomes. Results: The study identified that approximately 45.2% of the patients received monotherapy, whereas 24.1% received a combination of 2 drugs. Patients treated with a combination of 3 drugs were more likely to conceive (adjusted odds ratio = 4.10; 95% CI, 1.29-13.02; P = 0.02) than those without treatment. Conclusions: Patients treated with combination therapies had higher chances of conception than those without medications. However, a combination of nutritional and herbal therapies were associated with improved outcomes compared with conventional and nutritional supplements. The study's outcome could provide fertility specialists and stakeholders insight into choosing appropriate treatment options for prospective couples seeking fertility care. Consequently, fertility patients can access specific treatment options to meet their desired needs.

Pharmacotherapy of infertility in Ghana: Why do infertile patients discontinue their fertility treatment?

BACKGROUND: Globally, millions of people of reproductive age experience infertility. With that notwithstanding, most infertile patients undergoing pharmacotherapy withdraw from treatment before achieving the desired outcome. The reasons for their withdrawal, particularly in sub-Saharan Africa, have not been well examined, hence the need for this study. OBJECTIVES: The aim of the study was to examine why infertile patients discontinue pharmacotherapy prior to achieving conception. METHODS: The study employed an exploratory qualitative design. Purposive sampling technique was used to recruit subjects into the study. Twenty infertile patients (fourteen females and six males) who discontinued their treatment, and eight attending health professionals who provided direct care to these patients were interviewed. Telephone and face-to-face interviews were conducted using a semi-structured interview guide. The data collected were transcribed, coded, and generated into themes using thematic content analysis. RESULTS: The major reasons for discontinuation of infertility treatment included lack of support from male partners, seeking alternative treatment, unmet outcome, poor medical services, distance, stigmatization, and relocation. CONCLUSIONS: Patients and healthcare personnel shared both similar and diverse views on reasons for discontinuation of infertility treatment that reflect situations in a typical African setting, most of which are not reported in existing studies. The outcome of this study will provide insight for fertility therapists and policy makers in designing appropriate measures to facilitate maximum compliance and improvement in treatment outcome.