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.

Epidemiology and Sociodemographic Predictors of Infertility among Women in Ilorin, North-central Nigeria: A 5-Year Retrospective Longitudinal Study

“…20 The most commonly reported aetiological factor of secondary infertility in Nigerian women is chronic pelvic in ammatory disease which when comprehensively treated and managed would lead to reduction in the incidence of secondary infertility in the country. 21,22 Statistically signi cant sociodemographic factors found to have higher association with the development of secondary infertility in the participants in this study were higher age (≥ 30 years, P = 0.041), less than tertiary education status (P = 0.020) and being married in a polygamous marriage setting (P = 0.003). These ndings are similar to those reported by Oguejiofor et al in Nnewi, Southeastern Nigeria.…”

A 5-Year Retrospective Cross-Sectional Study of the Pattern of Infertility in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria

“…This high prevalence could possibly be due to poorly treated STIs, unsafe abortions, post-abortion sepsis and pelvic inflammatory diseases. However, Oriji et al noted that other plausible explanations for the high percentage of women with secondary infertility may include sexually transmitted infections, post-operative/procedure infections, and puerperal sepsis from previous deliveries supervised by unskilled/traditional birth attendants, which are all very common in our environment [17,21,22]. Secondary infertility in our environment has infectious origins at its core [22].…”