|AFRH CONFERENCE 2020 ABSTRACTS
|Ahead of print publication
AFRH Conference 2020 Abstracts
|Date of Web Publication||03-Aug-2021|
Source of Support: None, Conflict of Interest: None
| Abstract 1: Pattern of sperm quality among reproductive age men attending the ART clinic of UPTH, Port Harcourt|| |
Opurum HC1,2, Oriji VK1
1Department of Obstetrics and Gynaecology, Assisted Conception Unit, UPTH, 2Department of Medical Biochemistry, Faculty of Basic Medical Sciences, College of Health Sciences, University of Port Harcourt, Port Harcourt, Nigeria
Correspondence: Dr. Opurum Hamilton C, Department of Medical Biochemistry, Faculty of Basic Medical Sciences, College of Health Sciences, University of Port Harcourt, Port Harcourt, Nigeria.
E-mail: [email protected]
Introduction: Various reports have emphasized significant diminutions of semen quality globally for more than 50 years. Hence the development of assisted reproductive technologies to overcome some male factor challenges. Objective: This study was aimed at determining the pattern of Asthenozoospermia, Asthenoteratozoospermia, Azoospermia, Normospermia, Oligospermia, Oligoasthenozoospermia, Oligoasthenoteratozoospermia, Teratozoospermia and significant ancillary factors that may contribute to their outcome in reproductive age men. Materials and Methods: In this preliminary report, a comparative evaluation of the semen quality of consecutive male attendees at our facility over a 12 month period is presented. The WHO 5th edition guidelines for semen analysis was used and the statistical analysis using SPSS 21 with the significant level set at p = 0.05. Results: The patients were significantly older than potential donors (43.52±0.58 vs. 25.90±1.21, p=0.001). Although 41.9% of patients and 50.0% of potential donors were normospermic, the semen quality did not differ significantly between them (χ2 =11.26, p = 0.36). The relationship between semen quality and occupation of both patients and potential donors was not significantly different (χ2 =13.52, p = 0.49). Using the linear multiple regression, age, tribe and occupation were also not significantly associated with semen quality of study participants. Conclusion: The semen quality of patients and potential donors attending the ART clinic were relatively poor, they were not significantly determined by the age, various vocations, residence or tribes suggesting that other factors that require detailed research may be at play.
Keywords: Azoospermia, normospermia, oligospermia, sperm quality, teratozoospermia
Abstract 2: Intrauterine Adhesion is a More Prevalent Finding at Hysteroscopy than Sub Mucous Fibroid or Polyps among Infertile Sub-Sahara African Women Presenting for In vitro Fertilization Who Have Had Previous Uterine Surgical Procedures: A 15-Year Study
Ajayi AB, Ajayi VD, Afolabi BM1
Nordica Fertility Centre, Lagos Nigeria, 1Health, Environment and Development Foundation, Lagos, Nigeria
Correspondence: Dr. Victor Ajayi, Nordica Fertility Center, 106-108 Norman Williams Street, Southwest Ikoyi, Lagos, Nigeria.
Email: [email protected]
Objective: To determine which specific previous uterine surgical procedures was likely to have deleterious hysteroscopic findings and how much more likely. Materials and Methods: This was a retrospective study in which case records of 1631 Black African women who presented for ART from 2003 to 2018 were examined. Analysis was conducted with STATA 13 statistical software. Results: The means of age (years) and BMI (Kg/m2) were 38.7 (6.4) and 28.1 (5.3) respectively. Those who never had uterine surgery (n=276, 16.9%) were significantly younger (t-test=5.10, P-value=0.0000001) than those who had had uterine surgery (D and C, Caesarean C/S and myomectomy) (n=1,355, 83.1%). There was a significant variation (t=-4.32, P-value=0.0000001) in the mean duration of subfertility (years) among women who had no uterine surgery (5.9±5.0) and those who did (7.4±5.3). Sub-fertile women who had undergone various uterine surgeries (n=200, 14.8%) were 4.7 times more likely to present with intrauterine adhesions (IUA) (χ2=51.6, P-value=0.0.0000001, OR=4.73, 95% CI: 2.99, 7.50), 1.89 times more likely to present with polyps at hysteroscopy compared with women who had not undergone surgeries (χ2=14.55, P-value=0.0.001, OR=1.89, 95% CI: 1.36, 2.64), Conversely, Pooled analysis showed substantial variation (χ2=132.32, P-value=0.0000001) in the proportion of women who had pre-hysteroscopic D&C only and various hysteroscopic findings with IUA observed as having the highest prevalence (32.0%), followed by fibroid (14.5%) and uterine polyps (10.1%). Intrauterine adhesion was also most prevalent (41.8%) among women who had pre-hysteroscopic D&C and myomectomy (χ2=82.84, P-value=0.0000001) and among those who had multiple pre-hysteroscopic surgical procedures such as D&C, C/S and Myomectomy. Conclusion: IUA was most prevalent among sub-fertile women especially among those who had undergone previous uterine surgical procedures of D&C, C/S and myomectomy. History of uterine surgical procedures and hysteroscopy among those presenting for fertility management is important.
Keywords: Black African women, hysteroscopy, intra-uterine adhesions, uterine surgical procedures
| Abstract 3: Covid-19 Pandemic: Impacts Survey of Fertility Practitioners in Nigeria|| |
Lateef Adekunle Akinola, Lateef Adekunle
Medison Specialist Women's Hospital, Lagos, Nigeria
Correspondence: Dr Lateef Akinola, Medison Specialist Women's Hospital, Lagos, Nigeria.
E-mail: [email protected]
Introduction: COVID-19 pandemic has created a huge disruption to the activities of physicians and other healthcare providers all over the world. Fertility centers, fertility practitioners and patients alike are not left out. Infertile couples and families also face significant disruptions to their treatment schedules, financial plans as well as uncertainty about when their fertility treatments will begin. This survey evaluates the impacts that COVID-19 pandemic will have on the budgetary and operational activities of Fertility Centers' and practitioners in Nigeria. Materials and Methods: A cross-sectional survey of registered fertility practitioners of the Association for Fertility and Reproductive Health of Nigeria (AFRH) carried out in 10TH to 15TH of April 2020. Results: Majority of the respondents felt that their fertility enters made a good adaptation to the new working environment. Majority agreed that services have been negatively impacted, while 78.08% of responding practitioners felt the pandemic had not resulted in staff retrenchments. Also, majority believe that business continuity and plan is not been disrupted by the pandemic. A third of the respondents use travel and exposure histories, physical examinations and taking temperature for diagnostic assessments. AFRH and NCDC performance and response to Covid-19 pandemic were rated to be above average. Conclusion: Covid-19 pandemic and its containment strategies negatively impacted work, services and budgetary needs of fertility practitioners in Nigeria, with no significant reduction in staff level.
Keywords: Fertility practitioners, COVID-19, cross-sectional survey, fertility centres.
| Abstract 4: Paracervical Block for Oocyte Retrieval: Experience at a Public Health Facility in Nigeria|| |
University of Ilorin Teaching Hospital, Ilorin, Nigeria
Correspondence: Dr. Lukman Omokanye, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
E-mail: [email protected]
Introduction: Transvaginal Ultrasound Guided Oocyte Retrieval (TUGOR) for in vitro fertilization is one of the most common minor surgical procedures. Despite this, it is stressful and painful for the patient and thus requires some form of analgesia with or without sedation. The effects of various anesthetic techniques used for TUGOR on reproductive outcomes remain controversial.
Aims and Objectives: This study assessed patients' perception of pain using paracervical block and its effect on IVF outcomes. Materials and Methods: A cross sectional study of 66 eligible patients that underwent assisted reproduction program in our facility. All clients were treated with antagonist protocol for Controlled Ovarian Hyperstimulation. Self- administered questionnaires were used as the research instrument. Pain was assessed using a 10cm Visual Analogue Scale while clients' overall satisfaction was rated using Likert scoring system. Results: Client's aged 32.8 ±3.4. More than half had primary infertility with mean duration of 4.6 ± 2.4. Female factor infertility was the commonest cause of infertility. The pregnancy rate per embryo transfer was 36.4%, miscarriage rate was 9.1%, while the live rate was 27.3%. The mean VAS scores at 1hour, 6 hours, 24 hours and at embryo transfer were 7.1 ± 2.8, 4.6 ±1.4, 2.8 ±1.2 and 1.0 ± 0.9 respectively. The mean Likert score was 2.4 ± 0.9. Conclusion: Paracervical block is a safe and effective anaesthesia/analgesia option for TUGOR. However a multimodal approach of analgesia/anaesthesia for TUGOR is recommended to further improve on clients' satisfaction and acceptance.
Keywords: Paracervical block, transvaginal ultrasound guided oocyte retrieval, in vitro fertilization, minor surgical procedures
| Abstract 5: Continuation and User Satisfaction of the Levornogestrel Intrauterine System Contraceptive in Nigeria|| |
Nwala A, Udoh E, Anyanti J, Fajemisin A
Society for Family Health, Justice Ifeyinwa Nzeako House, #8 Port Harcourt Crescent, Area 11, Garki, Abuja, Nigeria
Correspondence: Mr. Ekerette Udoh, Society for Family Health, Justice Ifeyinwa Nzeako House, #8 Port Harcourt Crescent, Area 11, Garki, Abuja, Nigeria.
E-mail: [email protected]
Introduction: The Levonorgestrel Intrauterine System (LNG IUS) is a highly effective hormonal intra-uterine contraceptive. However, service on the method is not widely available in Nigeria and little evidence exist on the dynamics of its use. We examined the continuation rate and satisfaction with the LNG IUS among the user population. Materials and Methods: This prospective longitudinal phone survey involved a baseline survey of users at 2-weeks post-insertion of LNG IUS, recruited from 40 clinics across 18 states in Nigeria, with follow-up survey at the third and twelfth-month. A total 209 users were interviewed at baseline, 98 at three-months and 73 at twelve-month. User family planning and LNG IUS use experiences were elicited, and the continuation and satisfaction with the method at three and twelve months were assessed. Results: At the 3 and 12-months post-insertion, 97% (95% CI: 91.2, 98.8) and 92% (95% CI: 83.2, 96.2), respectively, reported still using the LNG IUS, with none out of the few users who discontinued the method reporting a method failure. Discontinuation was mainly as a result of desire to get pregnant (25.0%), experiences of bleeding disturbances (18.8%) and weight gain (18.8%). High satisfaction with the LNG IUS, 77.1% at 3-months and 86.3% at 12-month post-insertion was reported. Satisfaction with LNG IUS was associated with not having headache/migraine (88.4%) and no pelvic discomfort (90.8%) at 12-month than experiencing headache (50.0%) and pelvic discomfort (50.0%) (p<0.05). Conclusion: High user continuation and satisfaction of the LNG IUS indicates a positive potential of the method as a contraceptive mix in Nigeria.
Keywords: Contraceptive method discontinuation, contraceptive method mix, levonorgestrel intrauterine system, Nigeria Family Planning