Pattern and outcome of infertility in Enugu: the need to improve diagnostic facilities and approaches to management

In Nigeria, infertility is a social for the childless couple due to the high premium placed on propagating oneself. To determine the pattern of infertility among women attending the gynaecological clinic of university of Nigeria Teaching Hospital, Enugu and to examine the outcome of management. A descriptive retrospective design study based on findings from the folders of infertile couples presenting at the gynaecological clinic of University of Nigeria Teaching Hospital over a five year period (2004 - 2008). The data were collected from all documented and laboratory findings. The data extracted from the case records were the socio-demographic characteristics of the patients, the type of infertility whether primary or secondary, the causes, and the treatment in the years under review. The outcome of management was also evaluated. These were analyzed using SPSS 12.0.1 for window version. The mean age of the women was 34.1 +/- 4.9 range 21 - 46) years. The prevalence of infertility was 5.5% of all outpatient gynaecological consultations. The cause of infertility could not be determined in 39.4% of cases, female factors were identified as the sole causes in 28.7% of cases, male factors as sole causes in 11.5% of cases, and combined male/female factors in 20.4% of cases. Secondary infertility accounted for 76.8% of infertility and primary infertility 23.2%. The age of the women and the educational level did not significantly influence the type of infertility the women presented with (P > 0.05). Tubal factor was identified in majority of cases and pregnancy was recorded in only 17.0% of the women. Secondary infertility is more prevalent in Enugu with tubal factor accounting for majority of the cases with identifiable causes. The outcome of treatment of infertility is poor. There is need to improve infertility diagnostic and treatment facilities and approaches in Enugu, Nigeria.