Infertility investigation: socio-demographic characteristics and dropouts of infertile women at Family Guidance Association of Ethiopia (FGAE)

Abstract

In order to determine the proportion of primary and secondary infertility, the 1991 - 1995 medical records of clients were revised and analyzed. Three thousand three hundred and eighty women indicated their desire to undergo infertility investigations and then counselled for (Visit I), but only 2570(76%) registered for investigation. Ninety six percent of the attendants of the infertility clinic were females, and 58.1% of the registered females were less than 30 years of age and 18% above 35 years. Twenty-two (21.6%) had no formal education and 40.2% had primary education. About 38 (38.3%) had secondary school education and above. The majority of the clients were married (95.0%), housewives (70.4%), and reside in Addis Ababa (87.5%). The cumulative dropout rate was 91.9% of which 86.1% were those who were lost to follow-up. Of the physically examined (2475), 195 (7.9%) were actively censored. The largest number of the dropouts was immediately after visit three followed by visit one. This review shows that only 7% of the counselled and 9.3% of the booked completed the preliminary infertility investigation schedule. Forty-two women reported pregnancy during the process and were excluded from the dropout list. The follow-up discontinuation in respect to all selected socio-demographic variables was again indicated to be highest immediately after visit three. The investigation completion rate is shown to increase with the level of education, and among merchants and office workers. About 50% of the clients sought medical assistance after five to 10-years of infertility. Irrespective of the type, the shorter the duration of infertility, the better was the investigation completion rate. The proportion of primary to secondary infertility was about 2:3. Many infertile women who sought medical assistance failed to complete the essential preliminary investigations and were lost to follow-up. Although further study is necessary to answer why they discontinued, the socio-demographic characteristics indicate that those who are likely to be better economically are better completers of the investigations. The fact that neither the institution nor other centers can make all the essential investigations like seminal fluid analysis, HSG, diagnostic endometrial sampling, etc. in one setting with affordable fee charge may have contributed significantly to this high dropout rate.


(Ethiopian Journal of Health Development, 2000, 14(2): 127-134)