Causes of Infertility of Couples Residing in Libreville

Introduction: According to the World Health Organization, globally one in six people experience infertility in their lifetime. Infertility is considered as a major and global public health issue. In most cases, women bear the burden of infertility to protect the male ego. Although men and women are equally likely to have fertility problems. The aim of this study was to identify the causes of infertility of couples residing in Libreville. Patients and Methods: This was a retrospective descriptive study performed over 2 years, from 1st January 2021 to 31st December 2022. Data was obtained from 162 couples attending the assisted reproduction department of the mother and child hospitals in Libreville. Statistical analysis was done using IBM SPSS Statistics version 22.0 software. Results: During the study period, 28.5% of couples could afford IVF treatment. The average for woman age was 39.1 ± 4.06 while the average age for male patients was 41.53 ± 7.08 years with minimum and maximum age of 34 et 66 years. More than half (58.6%) of female partners were employed in the public sector. Half of the male partners (50%) were employed in the private sector. The median duration of infertility was 6 years. Approximately 49.4% of couples were diagnosed with primary infertility. The most common causes of infertility in female patients were Fallopian tubes obstruction (53.2%), uterine factors (24.2%) and hormonal problems (19.6%). With regards to male factors infertility, testicular causes were predominant (53.6%). Oligoasthenoteratozoospermia were the major semen abnormalities (55.7%) found after semen evaluation. Both male and female partners were sub-fertile in 47.5% of cases. Unexplained infertility was found in 11% of couples. Conclusion: This study showed that the diagnostic of infertility faced by couples residing in Libreville should involve both male and female partner.

Factors Determining the Postponement of Schedule Gyneaco-Obstetric Surgery at CHUMEFJE in Libreville (Gabon)

The study aimed to identify factors causing delays in scheduled gynaeco-obstetric surgeries at CHUMEFJE in Libreville from January 2019 to July 2020. Through a 16-month observational survey, it was found that out of 346 scheduled procedures, 128 (36.4%) were postponed. Organizational issues in the operating theatre were responsible for 80.3% of these delays, with 95.3% being preventable. To enhance efficiency, improvements in operating theatre organization are recommended.

The Effect of Age on Male Infertility in Gabon

Background: Male age significantly affects semen parameters. However, there is no evidence on the impact of aging on semen quality in men residing in Libreville, Gabon. Objective: To determine the effects of age on semen quality of patients visiting the Reproductive Laboratory at the Academic Hospital Mère Enfant located in Libreville, Gabon. Methods: This descriptive and prospective study was performed between the 1st of October 2021 and 30st of September 2022. This study involved patients who had semen analysis as part of fertility check-up. Semen analysis was performed following the World Health Organization, 2010 guidelines. Semen parameters such as volume, leucocytes count, sperm concentration, sperm motility, norml morphology and vitality were used in the current study. Descriptive statistics were performed. The Chi-square test and the Fisher test were used as statistical tools for the analysis of data. The ROC curve was used to illustrate the data. Results: A total of 148 patients were included in the study. Male infertility prevalence was 77.03%. The average age was 41 years with minimum and maximum of 24 and 61 years respectively. Secondary infertility was predominant (66.9%). Patients displaying asthenozoospermia (22.3%) followed by those displaying oligoasthenozoospermia (OAT) isolated (1.4%) or not (11.6%) were the most frequent semen parameter abnormalities. Men aged more than 45 years were 4.4 times likely to have abnormal semen parameters. Odd = 4.4 (IC 95% = [3.3 - 14.7]). Staphylococcus haemolyticus infection was more prevalent. Conclusion: Male age was found to significantly influence semen quality.

LARCs after unsafe abortion in Libreville (Gabon): Women accept quickly but the time interval for the insertion is longer than that of injectable contraceptives

Objectives: To determine the percentage of women who accepted a LARC after abortion, specify the interval time for the insertion of the LARC and compare such interval time with that of injectable and oral contraceptives. Patients and Methods: This is a prospective, descriptive and comparative study conducted in Libreville (Gabon), from February 1, 2013 to August 31, 2013. After receiving post-abortion care (PAC), all patients with stable general states were counseled about three types of contraceptive methods: combined oral contraceptive pills, LARCs (Jadelle? implants, Copper IUDs) and injectable Medroxyprogesterone Acetate (DMPA). Results: 231 women received PAC and among them 215 (93%) wanted to use one of the three proposed contraceptive methods. At the end of the study, only 193 women (89.7%) used contraception and 22 others (10.3%) abandoned their intentions. LARCs were used by 31 (16.0%) women. The average period for the insertion of LARCs was 15.4 ± 15.5 days with extremes of 1 to 53 days. This period for the insertion of LARCS was significantly longer than that of other methods (p < 0.001). LARCs were inserted more often after the 2nd day than immediately (same day) with a highly significant difference (p < 0.0001). Conclusion: LARCs could constitute an appropriate approach to reducing unintended pregnancies in Gabon. However, in order to increase their rates of use, it is necessary to improve women awareness.