The prevalence and etiology of infertility in a tertiary specialist hospital in the Gambia

Background: Infertility is a public health problem that has received little or no attention in most sub-Saharan Africa, especially in the Gambia. The prevalence of infertility in the Gambia is increasing from 9.0% in 1998 to 14.3% in 2017. Tubal factor was the predominant leading cause for decades, but recent reviews suggest that male factor is driving the epidermic of infertility worldwide. Therefore, the aim of this study was to determine the prevalence and etiological factors of infertility in our practice. Methodology: The design was a retrospective quantitative study. Data collection tool was developed and variables were retrieved from case notes between August 2022 to March 2023 at a specialist hospital in the Gambia. The data were entered into a computer database and analyzed using descriptive statistics. Results: Total number of women in the reproductive age of 15–49 years that attended gynecology clinic was 1475. Two hundred eighty-five couples (285) had infertility. The prevalence of infertility is 19.3% ~1:5 couples. The causes showed male factor 69 (45.4%), ovulation disorder 34 (22.4%), tubal factor 20 (13.2%), uterine factor 8 (5.3%), and unexplained 21(13.8%). Ovarian factors showed age-related poor ovarian reserve. Overall, male factor infertility was 53%, and female factor infertility was 47%. Conclusions: The prevalence of infertility is increasing and male factor is 3-folds and 2-folds higher than tubal and ovarian factors, respectively. The study observed increasing desire of fertility among female in advanced age. Universal access to assisted reproductive technology is essential.