African Journal for Infertility and Assisted Conception

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Background: 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 Centre's and practitioners in Nigeria. Methodology: A question-based, cross-sectional survey of registered fertility practitioners of the Association for Fertility and Reproductive Health of Nigeria (AFRH) carried out on the 10^TH to 15^TH of April 2020. Results: Majority of the respondents felt that their fertility centers made a good adaptation to the new working environment. Majority agreed that services have been negatively impacted, while 64.42% of responding practitioners felt the pandemic had not resulted to 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 Nigerian Center for Disease Control (NCDC) performance and response to Covid-19 pandemic were rated to be above average. Conclusion: Majority of the AFRH fertility practitioners surveyed felt that Covid-19 pandemic and its containment strategies negatively impacted work, services and budgetary needs of fertility practitioners in Nigeria, with no significant impact on staff employments. Response and guidance from the Association for fertility and reproductive Health and the NCDC towards curtailing the spread of Covid-19 infections to their members and the Nigerian communities, respectively, were rated above average.

Context: Tubal factor sub-fertility accounts for approximately 12% of IVF treatment cycles performed in the UK. Current data suggests that following hysteroscopic tubal cannulation, patients can expect a comparable LBR of 22% and spontaneous CPR of 25-27%, versus a LBR of 21% and CPR of 36.3% per cycle of IV. Our study is a l retrospective study, looking at reproductive outcomes after hysteroscopic cannulation of proximal tubal disease. Aims: investigate the effectiveness of hysteroscopic tubal cannulation (HTC) for the treatment of patients with proximal tubal obstruction (PTO). Settings and Design: Retrospective study. Methods: All patients underwent HTC for either unilateral (n= 53) or bilateral PTO (n= 33) between 2009 and 2018. Fertility outcomes were collected over following 24 months. Results: Overall CPR and live birth rate (LBR) following successful HTC was 26.9% and 22.2% respectively. Patients aged 20-35 years achieved a significantly higher CPR (38.5% vs 8.33%; Odds ratio (OR) 6.875; 95% confidence interval (CI) 1.41-33.54) and LBR (30.8% vs 8.3% OR 5.5; 95% CI 1.118-27.1) compared to 36-45 year-olds.

Background: The question of whether body mass index (BMI) affects semen quality and male fertility is controversial and available evidence are inconclusive and poorly documented in Nigeria and Africa by extension. Aim and Objectives: The study was conducted to correlate body mass index, sperm parameters and testicular volume in men with infertility presenting to the urology division, University of Abuja Teaching Hospital, Gwagwalada Abuja. Material and Methods: This was a prospective cross- sectional study. Male patients with infertility who presented to Urology Division University of Abuja Teaching hospital were recruited into the study. The weight of the subjects were measured using digital scale in kilogram and the height of the subjects were measured in meters and BMI calculated. The testicular volumes of all the subjects were measured using Prader orchidometer. The semen samples were collected by the process of masturbation on day five of sexual abstinence and analyzed according to WHO 2010 criteria. Collected data were analyzed using SPSS version 20. Results: The mean BMI of the subjects was 25.97±4.57kg/m2 with a range of 18.80-44kg/m2. The mean testicular volume using the orchidometer was 12.02±3.55ml. Subjects with normal BMI were 39(45.9%), overweight 32(37.6%) and 14(16.5%) of the subjects were obese. There was strong significant negative correlation between BMI and semen concentration using Pearson correlation (r=-0.591, P=0.000), and sperm motility (r=-0.569, P=0.000). Conclusion: Although it is difficult to generalize our results to the overall population, our results suggest that increased BMI has a deleterious effect on semen concentration and sperm motility. Therefore, to ensure maximum fertility potential, patients may be advised to prevent excessive weight gain as well as reduce weight amongst the obese.

Introduction: Transvaginal sonography (TVS) and hysteroscopy are useful in investigating causes of intrauterine pathologies. Aim: To compare the diagnostic yield of TVS with hysteroscopy for the evaluation of uterine cavity anomalies in female Nigerian patients. Materials and Methods: This is a cohort study of patients referred with infertility and abnormal uterine bleeding that were consecutively evaluated with TVS by a radiologist and confirmed by hysteroscopy at a multi-disciplinary endoscopy centre in Port Harcourt metropolis, Nigeria. Study period was from June 2014 to November 2019. Variables collated were sociodemographic, radiological, and endoscopic findings, sensitivity, specificity, and predictive values. Statistical analysis was with SPSS version 20. Results: A total of 99 patients had hysteroscopy but 52 patients included in study. The age of patients ranged from 25 – 56 years; mean age of 39.4 ± 6.0 years. The sensitivity and specificity of TVS for detection of intracavitary uterine anomalies were 78.7% and 100% respectively. The positive and negative predictive values were 100% and 33.3% respectively. There was additional detection of intramural ± subserosa myoma by TVS alone in 28(53.8%) patients and ovarian cysts in 5(9.6%) patients. Conclusion: TVS is an effective screening tool for preoperative triage of women with infertility and abnormal uterine bleeding requiring therapeutic intervention for intracavitary uterine anomalies. Hysteroscopy remains the gold standard for diagnosis of endometrial pathologies.

Online since 12^th Aug, 2016