IN VITRO FERTILIZATION (IVF) OUTCOMES AND PREDICTING FACTORS IN A RESOURCE-LIMITED SETTING

Abstract

Abstract

Introduction

Ethiopia has only one public In-vitro fertilization (IVF) center which was opened one year back. The aim of the study is therefore to determine predictors of the outcome of IVF in the only and newly opened public fertility center in Addis Ababa, Ethiopia.

Methods

The study is conducted in the public IVF center in Ethiopia between; April 01, 2019, to March 30, 2020. A retrospective cross-sectional study design was employed. All IVF clients meeting the inclusion criteria were included in the analysis.

Result

There was a total of 199 couples included in the study. The clinical pregnancy rate was found to be 30.1%. The odds of getting pregnant is 61% less among participants with female partners age ≥35 years, AOR 0.39, CI 0.18-0.83 with a p-value of 0.015. Good responders ((≥4 oocytes retrieved) accounts for 152(76.4%) of the cases. Age of female partner, day 3 Follicle Stimulating Hormone (FSH), and Antral Follicle Count (AFC) count ≥5 were significantly associated with good ovarian stimulation response with a p-value of 0.050,0.002 and 0.005 respectively.

Conclusion

Even though near two-third of the study participants did not know their exact date of birth, the reported age of female partner <35 years is associated with both good ovarian response and occurrence of pregnancy emphasizing its importance for clinical decision making. Day 3 FSH and AFC ≥5 were associated with good ovarian stimulation response. Therefore, we recommend the combination of female partner age, day 3 FSH, and AFC ≥5 to predict ovarian response in low resource settings, since variables can be readily available without much cost to patients. Furthermore, we would like to recommend follow up studies with better sample size and prospective cohort design to appropriately compare the different predictors of ovarian response in our setting to develop evidence-based set up specific IVF protocols and guidelines

Keywords: Pregnancy rate, IVF, Resource limited setting, Predictors, Infertility, Ethiopia