Secondary Infertility in Port Harcourt: Pattern and Socio-Dermographic Relationship

Abstract

Background: Secondary Infertility is viewed as a social stigma, especially in Nigeria, due to the high premium placed on procreation. Observation suggests that this condition is on the increase in our environment. Hence, the need to determine the pattern and the relationship between the socio-demographic factors with infective causes of this condition; which will subsequently allow the tailoring of the individual investigation and subsequent treatment. Objective: To determine the prevalence and pattern as well as the relationship between the socio-demographic factors with infective causes of secondary infertility among women who attended the gynaecological clinic of the University of Port Harcourt Teaching Hospital (UPTH) between January 2012 and December 2016 Methods: This is a retrospective descriptive study design, based on findings from the folders, admission and outpatient registers, of infertile couples presenting at the gynaecology clinic of the University of Port Harcourt Teaching Hospital, over a five-year period (January 2012 – December 2016). Data were collected from all documented and laboratory findings. The data extracted from the case records were the socio-demographic characteristics of the patient, the duration of infertility as well as the causes. They were analyzed using SPSS version 20. Results: The mean age of women was 33.14±4.93 years. The prevalence of secondary infertility was 12% of all outpatient gynaecological consultation. The mean duration of secondary infertility was 3 years. The infective causes of secondary infertility [recurrent pelvic inflammatory disease(PID), sexually transmitted infections(STI), post abortal sepsis, puerperal sepsis, HIV/AIDS, mumps orchitis were commoner among the 31-40 years’ category, (45.8%), the infective causes were also commoner among women with primary level of education, (62.5%, p-value=0.001) as well as women who were self-employed (49%, p-value=0.041). Recurrent pelvic inflammatory disease was identified in majority of cases (37.1%). Abnormal semen analysis, hyper-prolactinaemia and uterine fibroid, also contributed significantly to infertility; 18.5%, 19.7% and 24.3% respectively. Conclusion:  Infective causes are at the root cause of secondary infertility; the more educated the couple, the higher their socioeconomic status, the lesser the impact of infection on secondary infertility.