Pharmacotherapy of infertility in Ghana: Why do infertile patients discontinue their fertility treatment?

Abstract

Background Globally, millions of people of reproductive age experience infertility. With that notwithstanding, most infertile patients undergoing pharmacotherapy withdraw from treatment before achieving the desired outcome. The reasons for their withdrawal, particularly in sub-Saharan Africa, have not been well examined, hence the need for this study. Objectives The aim of the study was to examine why infertile patients discontinue pharmacotherapy prior to achieving conception. Methods The study employed an exploratory qualitative design. Purposive sampling technique was used to recruit subjects into the study. Twenty infertile patients (fourteen females and six males) who discontinued their treatment, and eight attending health professionals who provided direct care to these patients were interviewed. Telephone and face-to-face interviews were conducted using a semi-structured interview guide. The data collected were transcribed, coded, and generated into themes using thematic content analysis. Results The major reasons for discontinuation of infertility treatment included lack of support from male partners, seeking alternative treatment, unmet outcome, poor medical services, distance, stigmatization, and relocation. Conclusions Patients and healthcare personnel shared both similar and diverse views on reasons for discontinuation of infertility treatment that reflect situations in a typical African setting, most of which are not reported in existing studies. The outcome of this study will provide insight for fertility therapists and policy makers in designing appropriate measures to facilitate maximum compliance and improvement in treatment outcome.

A Systematic Review on Dropout of Infertility Treatments and Related Factors

“…In spite of these findings, in many areas of the world, both men and women are hesitant to blame infertility to the male partner, a feature considered to contribute to the low number of males seeking fertility therapy. 12,21 Surprisingly, financial problems were not given as a reason to stop treatment. When we did our study in Belgium, most of the cost of the medicine to stimulate the ovaries was covered, but the lab costs for IVF/ICSI were not covered and patients had to pay a lot per cycle (about 1,500-2,000 EUR).…”

“…Arhin, et al (2022) 12 showed the most common reasons for stopping infertility treatment were a lack of support from male partners, looking for alternative treatments, unfulfilled outcome expectations, unsatisfactory medical services, physical distance, social stigma, and moving away from the original treatment center. They asked patients and healthcare providers why infertile people stop fertility treatment before conceiving.…”

Pharmacotherapy for Infertility in Ghana: A Prospective Study on Prescription Patterns and Treatment Outcomes among Women undergoing Fertility Treatment

“…For example, our recent report revealed that prolonged pharmacotherapy of infertility without the desired outcome might lead to apathy, increased financial burden, psychological distress, and subsequent withdrawal from treatment. 7 Therefore, increasing the expected outcome of pharmacotherapy for infertility by employing evidence-based treatment protocols may significantly reduce treatment discontinuation and its associated psychological distress.…”

“…Considering the high preference for pharmacotherapy in managing infertility in the subregion, extensive and meticulous studies to ascertain the outcome of these treatments cannot be overemphasized. 7 Nonetheless, no study properly and convincingly evaluates the outcome of pharmacotherapy for infertility among women seeking fertility treatment in the subregion because data on conception rates remain scanty. Among the few related studies conducted in Southeast Nigeria focused only on conventional therapy, although other modes of treatment such as nutritional and herbal therapies form an integral treatment modality in sub-Saharan Africa.…”

Exploring the psycho-social burden of infertility: Perspectives of infertile couples in Cape Coast, Ghana

“…Fertility treatments can be financially burdensome, physically demanding, and emotionally draining on couples [ 12 ]. Fertility treatment in Ghana can be financially burdensome as it is not covered under the National Health Insurance Scheme (NHIS) and couples have to fully pay for all services and treatment [ 13 ]. By unravelling the psychosocial contexts of infertility, this paper aims to uncover the nuances, offering insights that may guide clinicians, counsellors, and support groups in providing more comprehensive care.…”