Why early, adequate testing minimizes pain, unexplained infertility cases —Study

IN a new study, experts say that early diagnosis of illnesses such as hypertension, fibroids, diabetes and hepatitis among infertile or sub-fertile women can minimize pain, cut cost of hospitalization and minimize the number of patients with unexplained infertility.

The study had observed a significant link between infertility and hepatitis and between infertility and fibroids in women in child-bearing age group with primary and secondary infertility at a tertiary health care facility in Lagos.

Primary infertility is when a pregnancy has never been achieved by a person, and secondary infertility is when at least one prior pregnancy has been achieved.

The researchers said gynecologists and fertility experts in sub-Saharan Africa should probe for these diseases in each patient who presents with infertility, after excluding male factor as contributing to female infertility.

According to them, female infertility may not occur alone but could be associated with other health conditions. Overlooking these health conditions during clinical assessment of women with primary or secondary infertility when they seek fertility treatment may not bring desired results of achieved pregnancy.

The researchers had set out to determine the frequency and relative risks of certain chronic illnesses such as hypertension and diabetes, infectious diseases such as hepatitis and other gynecological diseases such as fibroid and  endometriosis in women with primary and secondary infertility taking into consideration their age groups and Body Mass Index.

The overall prevalence of hypertension, diabetes, cancer and asthma in all patients were 9.6%, 6.8%, 0.8% and 0.4% respectively. Among the infectious diseases, hepatitis B occurred most frequently at 19.1%, more among women with secondary infertility (28.0%) than primary infertility (13.9%). It was in the September edition of the journal, Pregnancy & Child Birth.

The most prevalent gynecological diseases found in these women were fibroid (32.7%) and endometriosis (11.2%). There was a significant variation in the distribution of Polycystic Ovarian Syndrome (PCOS) relative to age, overweight, intrauterine adhesion in those with primary infertility but not in secondary infertility.

According to the study, screening for hepatitis should be incorporated and aggressively pursued as one of the run-ups for female infertility examination in sub-Saharan Africa. Further, a nationwide, population-based survey of hepatitis in Nigeria should be undertaken and reviewed on four-year basis.

They concluded that women with history of primary infertility are more at risk of diabetes, endometriosis and PCOS more than those with secondary infection.  Conversely, those with secondary infertility are more at risk of hypertension, hepatitis, fibroid and adenomyosis.

Diabetes is known to impact female and male fertility by causing hormonal disturbances with delayed or failed implantation and/or conception as consequences as well as poor sperm and embryo quality and damaged genetic mutations and deletions.

Hepatitis B virus (HBV) has also been known to negatively affect fertility. In women, it is associated with increased risk of tubal and uterine infertility and in men, it has been linked with increased risk of tubal infertility in their partner.