Characteristics of Sub-Saharan African Women Seeking Assisted Reproductive Technique (ART) and Outcomes

  • Opheelia makoyo komba Gynecology and Obstetrics service, Mother and Child Hospital-Foundation Jeanne Ebori (CHUME-FJE), Libreville/Gabon
  • Elisabeth Lendoye Laboratories services, Mother and Child Hospital-Foundation Jeanne Ebori (CHUME-FJE), Libreville/Gabon
  • Edgard Brice Ngoungou Research Unit in Epidemiology of Chronic Diseases and Health Environment (UREMCSE), Université des Sciences de la Santé. Libreville/Gabon
  • Pamphile Assoumou Gynecology and Obstetrics service, Mother and Child Hospital-Foundation Jeanne Ebori (CHUME-FJE), Libreville/Gabon
  • Ulysse Minkobame Gynecology and Obstetrics service, Mother and Child Hospital-Foundation Jeanne Ebori (CHUME-FJE), Libreville/Gabon
  • Lydie Moukambi Laboratories services, Mother and Child Hospital-Foundation Jeanne Ebori (CHUME-FJE), Libreville/Gabon
  • Emmanuelle Moungoyi Massala Mouima Laboratories Services, Mother and Child Hospital-Foundation Jeanne Ebori (CHUME-FJE), Libreville/Gabon
  • Jacques Bang Ntamack Laboratories Services, Mother and Child Hospital-Foundation Jeanne Ebori (CHUME-FJE), Libreville/Gabon
  • Jean François Meye Gynecology and Obstetrics service, Mother and Child Hospital-Foundation Jeanne Ebori (CHUME-FJE), Libreville/Gabon
  • Joel Fleury Djoba Siawaya Laboratories Services, Mother and Child Hospital-Foundation Jeanne Ebori (CHUME-FJE), Libreville/Gabon
Keywords: Infertility, Assisted reproductive technologies, In vitro fertilization, sub-Saharan Africa

Abstract

To describe the features of women seeking assisted reproductive technique (ART) in the Gabonese Republic (sub-Saharan Africa) and investigate In Vitro Fertilization (IVF) success in this sub-Saharan setting. In this retrospective study, we analyzed data of women on their first IVF round from January 1st, 2019, to December 31st, 2020. The Analyzed data included antimullerian hormone (AMH) levels, antral follicle count (AFC), number of mature oocytes collected, myomas, tubal obstruction, partner abnormality in the spermogram, and history of urogenital infection and pelvic surgery. Women seeking assisted reproductive techniques were characterized by a high prevalence of tubal obstructions (73.4%), myomas (39%), and a history of urogenital infection (35.5%). We retrieved a total of 1662 oocytes of which 1439 mature oocytes. The average serum AMH concentration was 2.33(+/-2.71) ng/ml while the average AFC WAS 14.63 (5+/-11.37). In up to 50% of infertile couples, a male factor plays a role. The rate of IVF procedures leading to live birth was 31%. Women who had gynecologic surgery had better odds of giving live birth (2.7 odds; p-value = 0.01). Our study showed that a high and combined burden of fallopian tubal obstructions, urogenital infection, and myomas characterize IVF candidates in Gabonese Republic. Also, the IVF success rate in this setting is close to what is observed globally.

Downloads

Download data is not yet available.

References

Ombelet W, Onofre J. IVF in Africa: what is it all about? Facts Views and Vision in Obstetrics and gynaecology. 2019;11(1):65-76.

Inhorn MC, Patrizio P. Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century. Human Reproduction Update. 2015;21(4):411-426.

WHO. Infertility. Health topics; 2020.

Nachtigall RD. International disparities in access to infertility services. Fertility and sterility. 2006;85(4):871-875.

Adegbola O, Akindele MO. The pattern and challenges of infertility management in Lagos, Nigeria. African Health Sciences. 2013;13(4):1126-1129.

Hörbst V. 'You cannot do IVF in Africa as in Europe': the making of IVF in Mali and Uganda. Reproductive biomedicine & society online. 2016;2:108-115.

Botha B, Shamley D, Dyer S. Availability, effectiveness and safety of ART in sub-Saharan Africa: a systematic review. Human reproduction open. 2018;2018(2):hoy003.

Dadhich P, Ramasamy R, Lipshultz LI. The male infertility office visit. Minerva urologica e nefrologica = The Italian journal of urology and nephrology. 2015;67(2):157-168.

Katz DJ, Teloken P, Shoshany O. Male infertility - The other side of the equation. Australian family physician. 2017;46(9):641-646.

Winters BR, Walsh TJ. The epidemiology of male infertility. The Urologic clinics of North America. 2014;41(1):195-204.

Carson SA, Kallen AN. Diagnosis and Management of Infertility: A Review. Jama. 2021;326(1):65-76.

Moragianni VA, Penzias AS. Cumulative live-birth rates after assisted reproductive technology. Current Opinion in Obstetrics and Gynecology. 2010;22(3):189-192.

Bosselut H, Paulmyer-Lacroix O, Gnisci A, Bretelle F, Perrin J, Courbiere B. (Prognostic factors of live-birth after in vitro fertilization for unexplained infertility: A cohort study). Gynecologie, obstetrique, fertilite & senologie. 2021; 49(7-8): 601-7.

De Neubourg D, Bogaerts K, Blockeel C, et al. How do cumulative live birth rates and cumulative multiple live birth rates over complete courses of assisted reproductive technology treatment per woman compare among registries? Human Reproduction. 2015;31(1):93-99.

Toftager M, Bogstad J, Løssl K, et al. Cumulative live birth rates after one ART cycle including all subsequent frozen-thaw cycles in 1050 women: secondary outcome of an RCT comparing GnRH-antagonist and GnRH-agonist protocols. Human reproduction (Oxford, England). 2017;32(3):556-567.

Published
2023-03-20
How to Cite
makoyo komba, O., Lendoye, E., Ngoungou, E. B., Assoumou, P., Minkobame, U., Moukambi, L., Mouima, E. M. M., Ntamack, J. B., Meye, J. F., & Siawaya, J. F. D. (2023). Characteristics of Sub-Saharan African Women Seeking Assisted Reproductive Technique (ART) and Outcomes. Journal of Infertility and Reproductive Biology, 11(1), 1-3. https://doi.org/10.47277/JIRB/11(1)/3
Section
Regular publication process (free of charge)