Characteristics of Sub-Saharan African Women Seeking Assisted Reproductive Technique (ART) and Outcomes

Abstract

To describe the features of women seeking assisted reproductive technique (ART) in the Gabonese Republic (sub-Saharan Africa) and investigate In Vitro Fertilization (IVF) success in this sub-Saharan setting. In this retrospective study, we analyzed data of women on their first IVF round from January 1^st, 2019, to December 31^st, 2020. The Analyzed data included antimullerian hormone (AMH) levels, antral follicle count (AFC), number of mature oocytes collected, myomas, tubal obstruction, partner abnormality in the spermogram, and history of urogenital infection and pelvic surgery. Women seeking assisted reproductive techniques were characterized by a high prevalence of tubal obstructions (73.4%), myomas (39%), and a history of urogenital infection (35.5%). We retrieved a total of 1662 oocytes of which 1439 mature oocytes. The average serum AMH concentration was 2.33(+/-2.71) ng/ml while the average AFC WAS 14.63 (5+/-11.37). In up to 50% of infertile couples, a male factor plays a role. The rate of IVF procedures leading to live birth was 31%. Women who had gynecologic surgery had better odds to give live birth (2.7 odds; p-value = 0.01). Our study showed that a high and combined burden of fallopian tubal obstructions, urogenital infection, and myomas characterize IVF candidates in Gabonese Republic. Also, the IVF success rate in this setting is close to what is observed globally.