The Causes of Infertility in Women Presenting to Gynaecology Clinics in Harare, Zimbabwe; A Cross Sectional Study

Abstract

Background Infertility affects 48.5 million couples globally. It is defined clinically as failure to conceive after 12 months or more of regular unprotected sexual intercourse. The contribution of various aetiological factors to infertility differs per population. The causes of infertility have not been assessed in Zimbabwe. Our objectives were to determine the reproductive characteristics, causes and outcomes of women presenting for infertility care.Methods A retrospective and prospective study of women who had not conceived within a year of having unprotected intercourse presenting in private and public facilities in Harare was done. A diagnosis was made based on the history, examination and results whenever these were deemed sufficient. Data was analysed using STATA SE/15.Results A total of 216 women were recruited. The mean age of the women was 32.9±5.7 years. Two thirds (144) of the women had primary infertility. The overall period of infertility ranged from 1-21 years with an average of 5.6±4.7 years whilst 98 (45.4%) of the couples had experienced 2-4 years of infertility and 94 (43.5%) had experience 5 or more years of infertility. About 1 in 5 of the women had irregular menstrual cycles with 10 of them having experienced amenorrhoea of at least 1 year. Almost half of the participants (49%) were overweight or obese. The most common cause for infertility was ‘unexplained’ in 22% of the women followed by tubal blockage in 20%, male factor in 19% and anovulation in 16%. Of the 49 (22.7%) women who conceived 21(9.7%) had a live birth while 23 (10.7%) had an ongoing pregnancy at the end of follow up. Thirty-seven (17.1%) had ART in the form of IVF/ICSI or IUI. Assisted Reproduction was significantly associated with conception.Conclusion Most women present when chances of natural spontaneous conception are considerably reduced. This study shows an almost equal contribution between tubal factors, male factor and unexplained infertility. Almost half of the causes are female factors constituted by tubal factors, anovulation and a mixture of the two. Improved access to ART will result in improved pregnancy rates. Programs should target comprehensive assessment of both partners and offer ART.

Role of Antioxidants of Natural Herbs in Management of Male Infertility

“…Through the regulation of the amounts of calcium within the cell, myo-ins control the oxidative metabolism of the mitochondria and the production of ATP in spermatozoa. Mitochondrial activity in sperm is improved by Myo-Ins, which has a positive impact on a wide variety of sperm processes [239], including capacitation, acrosome response, and motility regulation. This results in an increase in the motility of sperm in patients who already have aberrant sperm parameters [240].…”

The Concept of Infertility in Women: A Narrative Literature Review

“…movement disorders and blockages in the tubes as vital reproductive organs for conception to occur. [8][9][10][11] Sexual dysfunction in women that prevents penile penetration, such as vaginismus or dyspareunia and an extremely acidic vaginal environment, can significantly reduce sperm viability and lead to infertility. 12,13 Problems with the cervix uteri include physiological changes that normally occur during the preovulatory and ovulatory periods that make the cervical environment conducive to sperm viability, such as increased alkalinity and increased secretion.…”

The Synergetic Effect of Egyptian Portulaca oleracea L. (Purslane) and Cichorium intybus L. (Chicory) Extracts against Glucocorticoid-Induced Testicular Toxicity in Rats through Attenuation of Oxidative Reactions and Autophagy

“…In recent decades, infertility has impacted an increasing number of couples. Infertility affects 8-12% of couples worldwide, accounting for 48.5 million couples globally, and is one of the primary reasons for divorce [3]. Of all infertility cases, "male factor" infertility accounts for approximately half of couple infertility (40-50% of instances), and as many as 2% of all men will exhibit suboptimal sperm parameters.…”