Hysterosalpingographic Findings among Patients Undergoing Infertility Work-Up in Kisangani, Democratic Republic of the Congo

Nguma, Jean-Didier Bosenge; O’yandjo, Antoine Modia; Sialikyolo, Jeanot Juakali; Liogo, Gaston Litalema; Aundu, Antoine Molua; Kitoko, Roger Amisi; Bosunga, Gédéon Katenga

doi:10.4236/ojog.2019.92028

Cited by 6 publications

(1 citation statement)

References 12 publications

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“…Hormone assays were performed using Finecare TM (Guangzhou Wondfo Biotech Co., Ltd., PR China), a lateral flow fluorescence immunoassay technology using the sandwich immunodetection method. HSG was performed between days 7 and 12 of the menstrual cycle using the usual metal cannula system [45]. The spermiogram was performed and interpreted according to WHO recommendations [46].…”

Section: Laboratory Examinationmentioning

confidence: 99%

Comparative effectiveness of Sildenafil Citrate and Estradiol Valerate as adjuvants during Clomiphene Citrate-assisted ovarian stimulation cycles in Patients with unexplained infertility: A double-blind randomized controlled trial in Kisangani, DRC

Bosenge-Nguma,

O’yandjo,

Djang’eing'a

et al. 2024

Preprint

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Objective This study aimed to assess the effect of sildenafil citrate and estradiol valerate as adjuvant therapy during ovarian stimulation cycles with clomiphene citrate in patients with unexplained infertility to update infertility management guidelines in Kisangani. Method A double-blind, randomized controlled trial was conducted for two years (from October 1, 2021, to October 31, 2023). The population included 148 patients, 74 of whom were on clomiphene citrate + sildenafil citrate (CCSC) regimens and 74 of whom were on clomiphene citrate + estradiol valerate (CCEV) regimens for three months. The primary indicator was the conception rate, with secondary outcomes encompassing endometrial thickness, appearance and vascularity, the number of mature follicles and ovulation rate. Results Perifollicular flow was predominantly high-grade (P = 0.002), and the ovulation rate and clinical pregnancy rate were greater (P = 0.006) in the CCSC group than in the CCEV group. However, biochemical pregnancy rate, endometrial vascularity/thickness, and the number of Graafian follicles were not significantly different. The two groups were comparable in terms of sociodemographic and clinical characteristics. The mean duration of attempting to conceive was 4.39 years versus 4.36 years, and the mean AFC was 11.51 versus 11.46, respectively, in the CCSC versus CCEV groups. Secondary infertility was the most frequent type in each of the two participant assignment groups. Conclusion As an adjuvant, sildenafil increases the rate of clinical pregnancy more than does estradiol in patients with unexplained infertility undergoing ovarian stimulation with clomiphene citrate. However, both sildenafil citrate and estradiol valerate can protect the endometrium from the harmful antiestrogenic effects of clomiphene. Study registration: PACTR 202310849449401 ( Pan African Clinical Trials Registry)

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Section: Laboratory Examinationmentioning

confidence: 99%

Comparative effectiveness of Sildenafil Citrate and Estradiol Valerate as adjuvants during Clomiphene Citrate-assisted ovarian stimulation cycles in Patients with unexplained infertility: A double-blind randomized controlled trial in Kisangani, DRC

Bosenge-Nguma,

O’yandjo,

Djang’eing'a

et al. 2024

Preprint

View full text Add to dashboard Cite

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Comparation of two methods of surgery for myoma bleeding rate in open myomectomy cases: Ligation and using tourniquet

Ghaffari,

Mousavizadeh,

Aramesh

et al. 2023

Perioperative Care and Operating Room Management

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Tertiary care for infertile couples: aetiological diagnoses and conventional treatment outcomes in Kisangani, Democratic Republic of the Congo

Nguma

O’yandjo

Sihalikyolo

et al. 2023

Contracept Reprod Med

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Background In sub-Saharan Africa, tubal factors are described as the main aetiological factors of infertility. Under these conditions, medically assisted procreation is particularly indicated. However, Assisted Reproductive Technology centres are less available. Thus, infertile couples are quickly oriented towards available alternative conventional treatments. The present study aimed to determine the aetiological factors of infertility, the outcomes of the therapeutic options offered, and the factors associated with the success of conventional treatment among infertile couples seeking tertiary care in Kisangani. Methods A cross-sectional study was conducted at two tertiary health facilities in Kisangani. Infertile couples who provided consent underwent specific examinations necessary for the exploration of infertility and were treated and followed up for a minimum of 6 months. The therapeutic options that were offered were expectant attitude, medical treatment, surgical treatment or transfer to an in vitro fertilization unit. The pregnancy diagnosis was performed by ultrasound. Results A total of 272 infertile couples underwent specific examinations, were treated and were followed up for a minimum of 6 months. Many determinant causes were mostly linked to wives rather than husbands. Overall, only 34 women among 211 who were treated became pregnant during the follow-up period; 61 couples were advised to resort to IVF or adoption, but the couples for whom expectant the attitude was indicated immediately rejected it. The patients who therapeutically succeeded at the end of the treatment were those who were younger than 35 years (OR = 2.27; 95% CI = 1.06–4.87; P = 0.017), had a duration of infertility of less than five years (OR = 6.08; 95% CI = 1.79–20.69; P = 0.001) and had secondary infertility (OR = 6.08; 95% CI = 1.79–20.69; P = 0.001). Conclusion Kisangani faces a major issue in the treatment of infertility. Treatment of patients using conventional methods is limited by the predominance of tubal factors as aetiological determinants of infertility. The low pregnancy rate found in this study provided additional evidence of this. This paper represents a serious plea to national policy-makers to encourage them to pay attention to issues surrounding infertility.

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Hysterosalpingographic Findings among Patients Undergoing Infertility Work-Up in Kisangani, Democratic Republic of the Congo

Cited by 6 publications

References 12 publications

Comparative effectiveness of Sildenafil Citrate and Estradiol Valerate as adjuvants during Clomiphene Citrate-assisted ovarian stimulation cycles in Patients with unexplained infertility: A double-blind randomized controlled trial in Kisangani, DRC

Comparative effectiveness of Sildenafil Citrate and Estradiol Valerate as adjuvants during Clomiphene Citrate-assisted ovarian stimulation cycles in Patients with unexplained infertility: A double-blind randomized controlled trial in Kisangani, DRC

Comparation of two methods of surgery for myoma bleeding rate in open myomectomy cases: Ligation and using tourniquet

Tertiary care for infertile couples: aetiological diagnoses and conventional treatment outcomes in Kisangani, Democratic Republic of the Congo

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