Tubal Infertility at The Yaounde Gynaecological Endoscopic Surgery and Human Reproductive Research Teaching Hospital

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Abstract

Introduction: Tubal infertility affects 25% of infertile couples in Cameroon and is the leading cause of female infertility. Methods: We carried out a case-control study at the Yaounde Gynaecological Endoscopic Surgery and Human Reproductive Research Teaching Hospital, from the period of March to May 2021. Women with tubal infertility were grouped as cases and women with no fertility problems were grouped as the controls. Data of interest were sociodemographic, reproductive, surgical, medical, paraclinical, and therapeutic. Chi-square and Fischer's exact tests were used to compare variables. Odds ratios were calculated to determine the association between variables. A p-value of less than 0.05 was considered significant. Logistic regression analysis was performed to eliminate confounding factors. Results: Of the 205 patients recruited for the study, 67 had tubal infertility representing the cases and 138 with no fertility problems, representing the controls. After multivariate analysis and logistic regression, tubal infertility was associated in our study, with a history of sexually transmitted infections (aOR: 9.4; 95% CI [3.2-27.8]; p<0.001) and ectopic pregnancy (aOR: 13.5 95% CI [1.9-91]; p=0.009). The main diagnostic tools used were: hysterosalpingography alone (55.2%), hysterosalpingography followed by laparoscopy (40.3%). The main therapeutic approaches used were medically assisted reproduction (82.1%) and laparoscopic surgery (44.8%). Conclusion: The independent risk factors for tubal infertility were a history of sexually transmitted infections and ectopic pregnancy. The diagnosis was mainly by hysterosalpingography. Treatment was mainly by medically assisted reproduction.
雅温得妇科内窥镜手术与人类生殖研究教学医院输卵管性不孕
简介:输卵管不孕影响喀麦隆25%的不孕夫妇,是女性不孕的主要原因。方法:我们于2021年3月至5月在雅温得妇科内镜手术和人类生殖研究教学医院进行了一项病例对照研究。输卵管性不孕的妇女作为病例,无生育问题的妇女作为对照组。感兴趣的数据包括社会人口学、生殖、外科、医学、临床辅助和治疗。使用卡方检验和费舍尔精确检验来比较变量。计算比值比以确定变量之间的关联。p值小于0.05为显著性。采用Logistic回归分析消除混杂因素。结果:在研究招募的205名患者中,67名患有输卵管性不孕症,代表病例,138名没有生育问题,代表对照组。经过多因素分析和logistic回归,我们的研究发现输卵管性不孕与性传播感染史相关(aOR: 9.4;95% ci [3.2-27.8];p<0.001)和异位妊娠(aOR: 13.5 95% CI [1.9 ~ 91];p = 0.009)。主要诊断工具为:单纯宫腔输卵管造影(55.2%)、宫腔输卵管造影加腹腔镜检查(40.3%)。主要的治疗方式是医学辅助生殖(82.1%)和腹腔镜手术(44.8%)。结论:性传播感染史和异位妊娠是输卵管性不孕症的独立危险因素。诊断主要依靠子宫输卵管造影。治疗主要是借助医学辅助生殖。
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