Types of Infertility and Its Risk Factors among Infertile Women: A Prospective Study in Dhaka City

Background: Infertility is a global health issue, and it is a multidimensional problem with social, economic, and cultural influences. Objectives: The study aimed to determine types of infertility and their contributing factors among the respondent infertile women. Methods: This prospective cross-sectional study was conducted among infertile women visiting Sir Salimullah Medical College and Hospital, Dhaka. From January to December 2020, 111 infertile women were included and evaluated for infertility types and their contributing factors. Data were collected by face-to-face interviewing, and data were analyzed statistically. Results: Primary infertility was found among 90 (81%) and secondary infertility among 21 (18.9%). Among the direct risk factors of female infertility, ovulation failure was the majority of the cases, 74 (35.1%), and its mainly observed in primarily infertile women 58 (33.9%). These observations were statistically significant. Conclusions: Infertility should be treated as a public health problem, government and non-government organizations should develop a basic policy to create effective fertility centers.

Knowledge, attitudes, and practices regarding Covid-19 and their relationship with Covid-19 booster vaccination status among women with infertility

Objective:To elucidate the relationship among knowledge,attitudes,and practices regarding Covid-19 and their relationship with booster vaccination status among women with infertility.Methods:This questionnaire-based cross-sectional study was performed online and offline among women with infertility who visited an infertility clinic in Jakarta,Indonesia.We assessed the patient’s knowledge,attitudes,and practices regarding Covid-19 and their relationship with booster vaccination status and sociodemographic profile.Results:A total of 178 subjects participated in this study,and most participants(92.6%)had received booster Covid-19 vaccines.From the questionnaire,74.2%had good knowledge,and 99.4%had good attitudes regarding Covid-19;however,only 57.9%of patients had good practices.A weak positive correlation existed between knowledge and attitudes(r=0.11,P=0.13)and a moderate negative correlation between attitudes and practices(r=-0.44,P=0.56).Participants’knowledge about vaccines and infertility was correlated with booster vaccination status(P=0.04).Academic background(P=0.01)and attitudes(P=0.01)were also correlated with booster vaccination status.The significant determinants of hesitance of receiving Covid-19 booster vaccines were high school education or below(OR=0.08,95%CI 0.02-0.36)and poor practices(OR=0.21,95%CI 0.05-0.95).Conclusions:The majority of the participants had received the Covid-19 booster vaccine and had good knowledge and attitudes but poor practices regarding Covid-19.Most participants had poor knowledge about the relationship between infertility and the Covid-19 vaccine.The general population should be more informed and reminded about practices to prevent Covid-19 and the relationship between vaccination and fertility to increase the number of people who receive Covid-19 booster vaccines.

Psychiatric Aspects of Egyptian Women with Unexplained Infertility

Background: The diagnosis of unexplained infertility may be very frustrating for infertile couples and they show higher depression levels when compared to fertile couples. Aim: To assess the psychiatric aspects of Egyptian women with unexplained infertility. Methods: 220 infertile women were included in this study (110 with unexplained infertility and 110 with explained infertility). The psychiatric aspect of these women was evaluated using the translated and validated Hamilton Anxiety Rating Scale and the Beck Depression Inventory-II. Findings: The number of women with mild depression was significantly higher in the unexplained infertility group (47/110 (42.7%)) versus (22/110 (20%)) in the explained infertility group (P = 0.007). The number of women with moderate anxiety was significantly higher in the unexplained infertility group (26/110 (23.6%)) versus (8/110 (7.3%)) in the explained infertility group (P = 0.003). Conclusion: The current study concluded that mild depression and moderate anxiety were significantly higher in the unexplained infertility group. It is crucial to identify infertility women who are in need of psychological support and counseling during infertility treatment, because the psychological disturbance of the infertile women may affect the outcome of infertility treatment.

Serum leptin level in Sudanese women with unexplained infertility and its relationship with some reproductive hormones

BACKGROUND The excessive concentration of leptin has negative effects on all aspects of female reproduction.Despite this established relationship,the exact role of leptin in women’s fertility is not clear enough and needs more clarification.AIM To evaluate the serum leptin levels in Sudanese women and to ascertain the relationship between serum leptin levels and unexplained infertility(UI).METHODS A matched(age and body mass index)case-control study was conducted from March 2021 to February 2022.The study samples were 210 women with UI and 190 fertile women of reproductive age who were attending the maternity hospitals and fertility clinics in Khartoum state Sudan.The serum concentration of leptin and other serum biomarkers were determined using enzyme-linked immunosorbent assays.RESULTS The results showed that there was a highly statistically significant difference between the two groups(P<0.001)for all examined eight biomarkers.Whereby,leptin,luteinizing hormone(LH)/follicular stimulating hormone(FSH)ratio,prolactin hormone(PRL)and testosterone(T)were significantly higher in the UI group compared with the control group.In contrast,FSH and estradiol(E2)/T ratio were significantly lower in the UI group than in the control group and the effect size test for the difference between the two groups was very large(effect size>0.80),for leptin level,LH/FSH ratio,PRL level,and E2/T ratio,and large(effect size 0.50-≤0.80)for FSH and T.CONCLUSION This study reveals that leptin could be a potential biomarker for UI in Sudanese women and it may be useful for identifying women with a high risk of infertility.

Effect of Yangjing Zhongyu Decoction (养精种玉汤) on MatrixMetalloproteinase-9 Expression in Endometrium and SexHormone Regulation in Women with Cryptogenic Infertility

Objective: To investigate the effect of Yangjing Zhongyu decoction (YZD, 养精种玉汤) on metalloproteinase-9 (MMP-9) and its inhibitor-1 (TIMP-1) expression and sex hormone regulation in mid-luteal phase endometrium of women with cryptogenic infertility. Methods: Twenty-two infertile women were treated with YZD for 30 days successively. During the mid-luteal phase, in situ hybridization and reverse transcription-polymerase chain reaction method was used to detect MMP-9 and TIMP-1 mRNA, and radioimmunoassay was used to determine levels of serum estradiol (E2) and progesterone (P) synchronously. Results: After treatment, the mid-luteal serum E2 and P level were 451. 501 ± 226. 342 pmol/L and 46. 502 ± 19. 948 nmol/L respectively, significantly higher than that before treatment (304.656 ± 135.853 pmol/L and 33. 782 ± 15. 459 nmol/L respectively) , the difference was significant ( P < 0. 01). Staining of MMP-9 mRNA positive granules in cytoplasm and nuclei of adeno-epithelial cell in mid-luteal phase endometrium deepened significantly, but the change in mesenchym was insignificant. The MMP-9 mRNA expression after treatment was 0.617 ± 0.186 (grey level), significantly higher than the level before treatment (0.490 ± 0. 370), comparison between them showed significant difference ( P < 0. 05 ) . Change of TIMP-1 mRNA expression in adeno-epithelial and mesenchym before and after treatment was insignificant (0. 588 ± 0. 191 vs 0. 621 ± 0. 146,P>0. 05). Correlation analysis showed that the quantitative difference of P level before and after treatment was positively correlated with the difference of MMP-9 mRNA before and after treatment (r=0. 682, P< 0.01). Conclusion: YZD could soothen Gan(肝) and nourish Shen(肾) , raise the level of mid-luteal phase serum P, and further promote MMP-9 gene expression in endometrium to benefit the degradation of extracellular matrix of endometrium, and facilitate for blastocyst implantation.Original article on CJITWM (Chin) 2004 ;24 (4): 294

Clinical and investigative correlates of etiologic risk factors on treatment outcome of intrauterine adhesion in women with infertility: A descriptive study

Background: Intrauterine adhesion is a clinical entity that may present with subfertility. However, outcome of management depends on severity of intrauterine adhesion and type of treatment intervention employed. Objective: To evaluate clinical and investigative correlation of etiologic risk factors of intrauterine adhesion on fertility and pregnancy outcome following treatment. Patients and Methods: A 5 years prospective observational study. Treatment employed includes transvaginal blind intrauterine adhesiolysis, insertion of inert intrauterine device or inflated Foley’s catheter balloon and oestrogen therapy. Inclusion criteria are intrauterine adhesion as the only identifiable cause of infertility and post treatment follows up for at least a year. Results: Over a period of 5 years, 63 patients with mean age of 31.6 years and age range of 21 to 42 years were managed. Etiologic risk factors were dilatation and curettage 33 (52.4%), vacuum aspiration 13 (20.6%), myomectomy 11 (17.5%) and caesarean section in 6 (9.5%) patients. Of the 63 patients, 28 conceived giving a pregnancy rate of 44.4%. Nine out of the 28 patients that conceived had miscarriage, giving a miscarriage rate of 32.1%. The highest pregnancy rate and lowest miscarriage rate were recorded in the subgroup that had vacuum aspiration as their etiologic risk factor. Late pregnancy complications encountered are preterm contractions 5 (26.3%), placenta praevia 4 (21.1%), morbidly adherent placenta 5 (26.3%) and preterm delivery in 2 (10.5%) patients. Route of delivery was per vaginum in 13 (68.4%) patients and by caesarean section in 6 (31.6%) patients. Live birth rate was 89.5% (17/19 deliveries). There was no maternal mortality recorded. Conclusion: Compared to other risk factors, uterine vacuum aspiration was associated with higher fertility rate and better pregnancy outcome.

Leptin levels in women with unexplained infertility:A systematic review and meta-analysis

BACKGROUND Unexplained infertility(UI)is usually used for any heterosexual couple who failed to have a successful clinical pregnancy without identifying clear causes after they undergo all standard fertility tests.Evidence shows that leptin is one of the most accurate biomarkers for UI.Nevertheless,conflicting results regarding leptin levels in women with UI have been reported.AIM To find the serum leptin levels in women with UI.METHODS All studies written in English and conducted before April 30,2021 from PubMed/MEDLINE,Embase,Cochrane Central Register of Controlled Trials,ClinicalTrials.gov,Google Scholar,OpenGrey,OATD,and the infertility conference abstract were included.Studies were found eligible if they provided the mean and standard deviation of leptin for the case group and control group.The quality assessment of individual studies was evaluated using the Joanna Briggs Institute Quality Assessment Tool.Data synthesis and statistical analysis were done using STATA software version 16.RESULTS A total of 378 studies were reviewed,and just six studies that fulfilled the eligibility criteria were included in this meta-analysis.The pooled result showed that leptin levels were significantly higher in women with UI compared to fertile women,with a standardized mean difference of 0.97(95%confidence interval:-0.49-2.43).However,heterogeneity across studies was highly significant(P<0.00001;I2=98.8%).CONCLUSION The results of this study suggest that leptin levels are elevated in women with UI compared with fertile women;hence,leptin could be a potential biomarker for UI in women,and it may be useful for identifying women with a high risk of infertility.

A Survey of Correlation Infertility Self-Efficacy with Behavioral Health Scales in Infertile Women

Background: Infertility is a unique medical challenge that can have health behavioral consequence on infertile women including lack of self-esteem, depression, anxiety, fertility problem in infertile couples. The aim of this study was to evaluate correlation between self-efficacy and health behaviors scales in infertile women. Methods: A cross sectional study was conducted on 89 infertile women with mild to moderate depression (Beck scores 10 - 47) who were recruited from Fatemeh Zahra Infertility and Reproductive Health Research Center. All participants completed Self-efficacy Inventory (ISE) and other health behavioral scales (e.g., the Beck Depression Inventory (BDI), Cattle Anxiety Scale (CAS), Fertility Problem Infertility (FPI), and GHQ). Pearson correlation coefficient and Spearman rho correlation coefficient were used to analyze the data. Variables were included in the study if they had a p-value

Endocrine Indices of PCOS in Women with Polycystic Ovaries but without Diagnostic Features of PCOS: A Study of an Infertility Clinic Population

Background: The presence of polycystic ovarian morphology (PCO) without the other characteristics of the polycystic ovarian syndrome (PCOS) is insufficient for the diagnosis of PCOS and there is little justification for follow up in endocrine clinics for women with PCO morphology alone. A few studies have been reported regarding the endocrine features of asymptomatic women with PCO with conflicting data about endocrine profiling. The aim of this study was to assess whether women with PCO, but who have no symptoms of PCOS differ, endocrinologically, from women with normal ovaries.?Methods: We analysed the results of ultrasound and endocrine investigations in 576 consecutive women who attended the infertility clinic between 1993 and 1995 at the Reproductive Medicine Unit of St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, UK. Results: Three hundred and twenty eight women had PCO and 248 had normal ovaries. Among the 328 women with PCO, 169 (51.5%) had PCOS according to Rotterdam criteria. The remaining women with PCO had no symptoms of the syndrome (n = 159);they had a history of regular menses, had proven ovulatory cycles and had neither clinical nor biochemical evidence of hyperandrogenism. However, these women had higher timed LH [median (IQR) 5.3 (4.2) IU/l vs 4.8 (3.4) IU/l, respectively;p = 0.044] and testosterone [2.0 (0.8) nmol/l vs 1.8 (0.8), respectively;p = 0.009] compared with women with normal ovaries (although by definition within the normal range). There was no difference in BMI or FSH between the two groups. Among the 169 women with PCOS, 45.0% (n = 76) were anovulatory without hyperandrogenism, 34.3% (n = 58) fulfilled the NIH criteria and 20.7% (n = 35) were ovulatory with hyperandrogenism. The proportion of hyperandrogenism among anovulatory women with PCO is 43.3% (58 out of 134).?Conclusions: Women with PCO, but no symptoms of the syndrome, differ endocrinologically compared with women with normal ovaries: they had higher timed LH and testosterone (although by definition within the normal range). These data suggest that despite the lack of symptoms of PCOS, women presenting to an infertility clinic with PCO represent a milder phenotype of those with overt PCOS, but fall on the same spectrum.

Diagnostic Accuracy of Sonosalpingography for Assessing Tubal Pathology in Women with Secondary Infertility Taking Laparoscopy as Gold Standard

Context: Secondary infertility is a major public health issue with growing urbanisation and increasing age of marriage among women. Disease limited to low socioeconomic strata is commonly seen in general population. Judicious and accurate assessment of underlying pathology targeting tubes should be undertaken. Aims: The aim of this observational study was to assess the diagnostic accuracy of sonosalpingography taking laparoscopy as gold standard in patients of secondary infertility. Main aim was to assess tubal factors as an underlying cause and to assess feasibility of a radiation free protocol in patients of reproductive age group. Settings and Design: The study was carried out in a hospital setting. A total of 123 patients were selected. Patients of primary infertility were excluded. Sonosalpingography was performed by a single experienced radiologist. This was confirmed by laparoscopy conducted by an experienced gynaecologist. Methods and Material: A detailed clinical and physical examination including internal examination was done. This was followed by sonosalpingography using high frequency TVS probe (Philips IU 22). All patients were subjected to laparoscopic evaluation on the same day. Statistical analysis: Sensitivity, specificity, diagnostic accuracy and predictive values. Results: Sonosalpingography was 72.91% sensitive, 81.33% specific with diagnostic accuracy of 78.05% and positive predictive value of 71.42% for tubal pathologies. Conclusions: Sonosalpingography is a very useful complementary diagnostic modality in assessment of tubal pathology. This should precede direct laparoscopic evaluation. Patients of secondary infertility can be assessed with a combination of sonosalpingography and laparoscopy. This saves the patient of radiation exposure as well as pain of contrast

Endometrial Injury and Sub Endometrial Doppler Study to Predict Uterine Receptivity in Women with Unexplained Infertility: A Randomized Controlled Trial

Objectives: The aim of this work was to compare the effectiveness and safety of endometrial scratching at different times of the menstrual cycle on cumulative pregnancy rate and also to assess and clarify its relationship and effect on sub-endometrial vasculature blood flow by Doppler ultrasound, in cases of unexplained infertility attempting to conceive spontaneously (without ovulation induction). Study Design: A prospective randomized clinical control study. Patients and Methods: A total of 252 eligible participants were included in the study and randomly allocated using block randomization into three groups: Group A (n = 84): endometrial scratching was performed during the pre-ovulatory days and Group B (n = 84): endometrial scratching has been done at day 7 of the cycle. Group C (control group): includes 84 cases without endometrial scratching. The Doppler ultrasound will be done. The pulsatility index (PI) and resistance index (RI) of endometrial and sub endometrial arteries were calculated. All women were followed up to 3 months. Results: Cumulative pregnancy rate is 21.42% and 28.57% in the study groups A and B respectively which is higher than group C (control group) (4.76%) but with statistically insignificant P-value = 0.254. There is statistically significant difference in RI & PI between the studied groups and the control group on day 13 (P value < 0.001). There is statistically significant difference in PI between day 13 and day 6 for the same group in both groups (A&B) (P value < 0.003), while there is no statistically significant difference in Group C (P value = 0.156). Conclusion: Endometrial scratching is a cost-effective and easy technique which may improve clinical pregnancy rates and endometrial blood flow in women with unexplained infertility.

Management of Women Infertility in Tropical Africa: The Experience of the Gynecology Department of University and Hospital Center of Treichville (Abidjan-Cote d’Ivoire)

Objectives: This study aimed to clarify the etiology of women infertility and describe their management in our service with limited technical equipment. Methodology: We conducted a retrospective and descriptive study on 175 women treated for infertility and followed in the gynecology services of the university Hospital center of Treichville from 1st January 2012 to 31st December 2014. Results: During the study, we recorded 12072 consultations in gynecology including 1582 (13.1%) cases of infertility, but only 175 cases were selected for this study. The patients had an average age of 31.3 years and an average socio-economic level in general (78.9%). The etiologies were found in 79.4% of patients, dominated by classical abnormalities: uterine (fibroids: 41.8%), hormonal, tubo peritoneal (5%). We also found some unusual pathologies related to cultural practices (female genital mutilation, caustic stenosis of the vagina). The surgery was performed in several patients, including myomectomy by laparotomy (46.6%), laparoscopy, hysteroscopy and vaginal surgeries. As to drug treatment, they were various combinations, and the ovarian stimulation practices (62.3%) and induction of ovulation (47.2%) were common. The result of this support has been marked by the occurrence of 74 pregnancies (42.3%), with the birth of healthy children in the majority of cases (95.9%). Conclusion: The management of infertile women was frequent and yielded encouraging results despite our limited technical equipment.

Prevalence of Polycystic Ovary Syndrome in Nigerian Women with Infertility: A Prospective Study of the Three Assessment Criteria

Background: Polycystic ovarian syndrome (PCOS) is a frequent diagnosis in oligomenorrheic and infertile Nigerian women. However, to date there is a paucity of data on the prevalence of PCOS in Nigerian women. The objective of this study was to investigate the prevalence of PCOS in a cross-section of women attending Infertility Clinics in Benin City, Nigeria using the three assessment criteria namely: the 1990 National Institutes of Health (NIH), the 2003 Rotterdam and 2006 Androgen Excess Society (AES) criteria. Method: Four hundred and twenty-one consecutive infertile premenopausal women aged 18 - 45 years were recruited and evaluated with a proforma that elicited information about their maternal and reproductive health history. Blood samples were analyzed for hormone levels using standard immunoassay procedures, while trans-vaginal ultrasound scan was carried out to determine the presence of ultrasonic features of PCOS. The control group comprised of eumenorrheics (n = 180). Results: An estimated prevalence of biochemical hyperandrogenism (BHA) was as high as 20.9% (88 women), while 3.6% (15 women) presented with clinical hyperandrogenism (CHA). Also the prevalence of polycystic ovaries (PCO) was 13.8%. The prevalence of PCOS based on NIH, Rotterdam and AES criteria was 16.9% (71 women), 27.6% (116 women) and 20.7% (87 women) respectively. However, women with PCOS were significantly younger and had higher total testosterone levels (p = 0.001) when compared to controls. Conclusion: The prevalence of PCOS is as high in the population under study as in other prevalence studies. The hormonal investigations were clinically useful in assessing the prevalence rates. However, the recruitment criteria, together with the regional and racial factors may have contributed to the estimates obtained, and the high incidence of biochemical hyperandrogenism in this region.

A Qualitative Exploration of South African Women’s Psychological and Emotional Experiences of Infertility

Despite the high prevalence of infertility in Africa, the study of reproductive health in Africa, has for the most part, not addressed the impact of involuntary childlessness on women. In contrast, the health priority has been on fertility regulation rather than on infertility. In Sub-Saharan Africa, at least 20% - 50% of couples of reproductive age experience a fertility problem and 30% are diagnosed with infertility. This study explored a sample of South Africa women’s psychological and emotional experiences of infertility or involuntary childlessness. Utilising a qualitative methodology, 21 married women who were diagnosed with infertility were recruited. Semi-structured, indepth individual interviews were conducted and the data were analysed using thematic analysis. The results of the study indicated that the women reported emotional turmoil characterised by emotions such as disappointment and shock, anger and frustration, a deep sense of sadness and then progressed to experience a sense of acknowledgement that a problem existed. Within each of these emotional phases the emotions of hope and optimism were present. The findings of this study suggest that severe psychological and emotional tug-of-war effects accompany infertility. Possible coping strategies for women struggling with infertility are discussed.

Clinical, Psychological and Socio-Economic Profile of Women Consulting for Couple Infertility in the Yaounde Gynaeco-Obstetric and Paediatric Hospital

Introduction: Infertility is defined as the inability to achieve a pregnancy after at least 12 months or more of regular unprotected sexual intercourse. Our main objective was to describe the clinical, psychological and socio-economic profile of women consulting for infertility in the Yaounde Gyneco-Obstetric and Pediatric Hospital. Methodology: This was a descriptive cross-sectional study with prospective data collection at the Yaounde Gyneco Obstetric and Pediatric Hospital over a period of 7 months from 1st December 2021 to 31st June 2022. Results: We included 171 patients. The mean age was 32.3 ± 5.5 years. The mean duration of infertility was 4.0 ± 3.7 years. Primary and secondary Infertility made up 31.6% and 68.4% of cases respectively. Past medical history was significant for Abortions (50%), Chlamydia and Mycoplasma infections (43.8%), chronic pelvic pain (49.7%) and endouterine manipulations (33.3%) of cases. Majority of our patients were stressed (76.6%). The most represented stress score was severe stress (66.1%). 51% of our patients were mentally depressed and 35.6% were anxious. Majority of them (74.9%) had low socio-economic status. Conclusion: Couple infertility is most often secondary. It triggers the onset of psychological problems like stress, mental depression and anxiety. Most of our patients had a low socio-economic status.

Awareness and perception of assisted reproductive technology practice amongst women with infertility in Northern Nigeria

Background: Involuntary infertility is a tragedy in most African setting. This is due to premium placed on fertility as a result of roles children fulfill in the family and the society. Aetiologic factors of infertility in sub-Saharan Africa are mostly infection related and they are mainly associated with poor treatment outcome to conventional non assisted conception technique. Objective: To evaluate the level of awareness and perception of assisted conception treatment among women attending fertility clinic. Methods: A descriptive cross-sectional study. Results: One hundred and ninety six women attending fertility clinic were interviewed. Mean age was 34.8year and mean duration of infertility of 4.1 years. Of the 196 infertile women interviewed, 150 (76.5%) have heard of Assisted Reproductive Technology treatment. Sources of information were mainly family relation (46%) and friends (28.7%). Knowledge on some of Assisted Reproductive Technology practices showed that 50.7% were aware that the treatment could fail, 36.8% knew it could be applied for male infertility treatment, 9.3% and 18.7% respectively are aware that donor oocyte and sperm could be used for treatment. Perception on babies conceived from assisted conception treatment revealed that 52% of patients interviewed could not comment if they are normal and natural babies. Majority of patients could not affirm if they will agree to the use of donor gamete or zygote for their treatment. Conclusion: Awareness of assisted conception treatment was high, however knowledge on specifics of treatment was low and perception on some of the practices was unfavorable. Sensitization of the public will help overcome some beliefs that may be at tangent to some practices of assisted conception.

Assessment of the Microbiome Collected from the Reproductive Tracts of Women from Saudi Arabia and Its Potential Influence on Infertility

Background and Objective: Female infertility may be attributed to several causes that are fundamentally related to the health status of women. The main objective of this project was to correlate the abundance of the microbiota in cervicovaginal fluid to infertility. Materials & Methods: A total of 36 married women who voluntarily came to the hospital in Riyadh for a routine visit participated in the study. To collect the cervicovaginal liquid, a SoftcupTM menstrual device was used by the participant;the cup was then transported in a liquid nitrogen box to the laboratory for analysis. Results: The mean vaginal pH in normal women and infertile women was 3.96 and 5.06, respectively, and the difference between the two cohorts was significant (p 5.5, is primarily composed of G. vaginalis, P. anaerobius, Mycoplasma hominis, Mobiluncus species and Atopobium vaginae. The protein content and viscosity of the cervicovaginal liquid were significantly lower in infertile women compared to normal women (p < 0.05).

Coping with Infertility: An Explorative Study of South African Women’s Experiences

The expectation of getting married and having children is for many individuals a natural part of adult life. Many young people anticipate the prospect of becoming biological mothers and fathers. This expectation of parenthood emanates as individuals and couples are socially groomed to aspire to this social norm. Therefore, infertility can be a very traumatic and tormenting time for many men and women who aspire to conform to these socio-cultural conventions of normative parenthood and who believe that childbearing is central to their lives. Infertility is medically defined as the inability to achieve a pregnancy after a period of at least twelve months of regular sexual intercourse without contraception. For both men and women infertility may present pervasive feelings of incompleteness, a sense of failure and inadequacy. However, infertile women tend to endure a myriad of feeling losses and high levels of suffering and sorrow as a result of their inability to have children. This study explored a sample of South Africa women’s experiences of coping with infertility. Utilising a qualitative methodology, a diverse group of 21 married women who were diagnosed with primary infertility were recruited. Semi-structured, in-depth individual interviews were conducted and the data were analysed using thematic analysis. The results of the study indicated that the women reported emotional turmoil characterised by emotions such as disappointment and shock, anger and frustration, a deep sense of sadness and then progressed to experience a sense of acknowledgement that a problem existed. The findings of this study suggest that severe psychological and emotional strain accompany infertility. The coping strategies employed by these women in the study included social withdrawal and women isolating themselves from social events and social gatherings, avoiding pregnant women and women with children, engaging in escapism strategies on both a psychological level and a physical level. Employing an escapism strategy on a psychological level would involve deliberately thinking about strategies to avoid thinking about infertility, pregnancy or babies. Escapism on the physical level would include engaging in activities like shopping, working longer hours, sleeping more than usual, engaging in activities that would occupy an individual to the extent that they cannot think about anything else except the activities they are currently engaged in.

Investigation Correlates of Chlamydia Anti-Body Testing and Hysterosalpingography among Women with Tubal Infertility

Background:?Chlamydia trachomatis?infection is an important preventable cause of infertility. In women, up to 70% of genital infection with?Chlamydia trachomatis?are asymptomatic. In the management of infertility patients, a lot of clinicians or centres do not routinely screen for?Chlamydia trachomatis?infection. Hence all patients being investigated for infertility may potentially be at risk of tubal blockage in addition to non-tubal factor aetiology. Those with primary tubal blockage also are at risk of worsening of the blockage. Objective: To determine if there is a relationship between IgG and IgM Chlamydia antibody testing (CAT) and tubal factor infertility. Design: It was a cross sectional descriptive study. Method: The sera of 400 consecutive consenting infertile patients presenting to the gynaecological clinic of the Ahmadu Bello University Teaching Hospital, Zaria, Northern Nigeria were tested for Chlamydia antibodies using ELISA IgG and IgM kits produced by Diagnostic Automation, Inc., 23961 Craftsman Road, Suite D/E/F, Calabasas, CA 91302, USA. Results: Up to 264 (66%) of the patients had tubal factor, 64 (16%) had uterine, 56 (14%) had ovarian, 50 (12.5%) had male while 40 (10%) had others. The causative factors were not mutually exclusive. The sero-prevalence of IgG and IgMChlamydia trachomatis?amongst patients with tubal infertility were 35.6% and 35.6% respectively. There was a stronger significant relation (P = 0.008) between IgM sero-positivity which suggests recent infection and tubal infertility. The relation between IgG sero-positivity which suggest chronic infection and tubal infertility was also significant (P = 0.036) but relatively lower. Conclusion: The sero-prevalence of?Chlamydia trachomatis?infection, IgG and IgM was significantly higher among the sub-population with tubal infertility. Chlamydia antibody testing (CAT) has predictive value for tubal infertility.

Detection of <i>Chlamydia trachomatis</i>and <i>Neisseria gonorrhoeae</i>in Egyptian Women Suffering from Infertility

Chlamydial and gonococcal infections are recognized as two of the major causes of sexually transmissible human bacterial infection which may lead to infertility. In this cross sectional study, we aimed to determine the prevalence of Neisseria gonorrhoeae, Chlamydia trachomatis among Egyptian women using different microbiological methods. One hundred and fifty cervical swabs were collected, of which 100 were from infertile women. Culture and ELISA technique were used for screening of Neisseria gonorrhoeae and Chlamydia trachomatis individually. In addition, PCR was used for all examined samples. For C. trachomatis, 3 cases were positive for antigen detection by ELISA. Moreover, in obtained results of PCR, DNA was detected in 4 samples, and three of them from infertile group. So based on PCR results, the sensitivity and specificity of ELISA were 75% and 100% respectively. Furthermore, 3 samples were positive for gonococcal infections by PCR, and two of them were taken from infertile women. Positive results of two samples were verified by culture. The estimated sensitivity and specificity of culture method were 66.7% and 100% respectively. Results of this study indicate that PCR is a valuable method for detection of gonococcal and chlamydial infection and it is suitable for the confirmation of ELISA results for C. trachomatis diagnosis. Culture method is less sensitive than PCR for detection of N. gonorrhoeae. The prevalence of such infections is higher among infertile women.