Factors associated with Infertility among Women attending the Gynaecology Clinic at University Teaching Hospital, Lusaka, Zambia

Abstract

Objectives: The objective of this study was to investigate and determine the factors associated with infertility in women attending the gynaecology clinic at the University Teaching Hospital (UTH) in Lusaka, Zambia. Methods: Using an unmatched case-control study design, women attending the gynaecology clinic for infertility were enrolled. Controls were randomly selected from women in the labour ward. An investigator-administered questionnaire was used to collect data. Bivariable analysis was used to determine association between infertility and demographic and previous gynaecological history. Odds ratios were used to determine statistical significance. Associations with a p<0.05 were further analysed by multivariable logistic regression. Results: One hundred and thirty women were selected as cases and 260 were selected as controls. Overall, primary infertility was found to be affecting 50/130 (38.4 percent) of the women while secondary infertility was found in 80/130 (61.5 percent). In bivariate analyses, the following variables were statistically significant at the 95% CI level: age group (20-29y OR 2.39; 30-39y OR 8.42); marital status (married OR 1.16; single OR 0.017); partner’s consumption of alcohol (OR 2.80); frequency of menses (irregular OR 2.27; regular 3.81);  whether they’d ever been pregnant (never been OR 151) having had an manual vacuum aspiration (MVA) (OR 0.24); having had a pelvic infection or operation (OR 0.18). In multivariable logistic regression analysis, five factors were independent and statistically significant correlates of infertility: age at menarche, frequency of menses, having a pelvic procedure done, and having an MVA done. Conclusion: The problem of primary infertility at UTH was similar to that reported in other sub-Saharan countries. Secondary infertility was more prevalent than primary infertility.  Infertility was found to be most prevalent among women aged 30-39 years. Of the factors studied, having had a pelvic procedure or an MVA was significantly related to being infertile. The most commonly ordered investigations were hormonal, HSG, USS and semenalysis.