Determinants of Infertile of Infertile Women Requesting Assisted Reproduction Techniques in a Low Resource Setting in Western Nigeria

Abstract

Background: Infertility is an important gynaecological condition with psycho-social, cultural, economic, religious, demographic, and clinical consequences. Although the prevalence of couples having problems with conception has remained relatively stable worldwide, there has been an increase in the proportion of couples seeking fertility services. This substantial increase might reflect the improvement in the advancements in fertility care, improved success rates, increased availability of specialists and or involvement of insurance firms in infertility treatment. Paradoxically, countries in Africa with high infertility burden still lags in fertility care. This study was therefore aims to investigate the types and causes of infertility in patients attending fertility care in an assisted conception Centre in a public tertiary hospital in southwest Nigeria. Methods: This was a retrospective study of patient records who attended Assisted fertility centre (AFC) of Lagos University Teaching Hospital (LUTH), from January 1st, 2015, to December 31st, 2023. Categorical variables were analysed using percentages while continuous variables were analysed using mean and standard deviation and the association between categorical variables was analysed using chi-square test. The statistical significance level was set at p-value < 0.05. Results:  The mean age and mean duration of infertility of the participants in the study was 40.89±6.8, and 8.14±3.5 respectively. About 72.9% had more than secondary education while almost two thirds of the participants had secondary infertility, 36.1% had previous pelvic surgeries, 11.4% had chronic pelvic pain and menstrual abnormality. Secondary infertility was more prevalent in women who has chronic pelvic pain, or those who has had previous pelvic surgery, previous infertility or previous abortion. Conclusion: In conclusion our analysis suggests that Secondary infertility is the commonest cause of inability to conceive in our facility. It also revealed that most of our women present late for fertility care at an advanced maternal age.