Ethiopian Journal of Reproductive Health

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

Lemi Belay, Thomas Mekuria , Mekitie Wondafrash — Tue, 03 Aug 2021 06:15:27 +0000

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

Precancerous Cervical Cancer Lesion and Associated Factors among Rural Women of Age 30 – 49 Years, in Sude District, Oromia Region, Ethiopia

Sileshi Garoma, Temesgen File, Fikadu Yadeta, Fikadu Yadeta — Tue, 03 Aug 2021 00:00:00 +0000

Purpose: To assess the prevalence of precancerous cervical cancer lesion and associated factors among women age 30-49 years in Sude district, Arsi Zone, Oromia Region, Ethiopia. Methods: Community based cross sectional study was conducted among 633 women age 30- 49 years from December 2019 to January 2020. Data were collected using structured and pretested questionnaires. Visual inspection with acetic acid was applied for screening by trained and experienced midwives. The collected data were entered and cleaned using Epi-Info-7 and exported to SPSS-21 for analysis. Bivariate and multivariable binary logistic regression analyses were conducted to determine the association between the study variables. Odds Ratio with its 95%CI was calculated and P- Value < 0.05 used as a cut off points to declare the significance. Result: The prevalence of precancerous cervical cancer lesion was 4.7% (95% CI: 3.2, 6.5). Being older age (AOR, 3.5; 95% CI:1.32, 9.39), widowed and divorced (AOR, 7.96; 95% CI: 2.84, 22.32), having multiple sexual partner (AOR, 2.8; 95% CI: 1.03, 7.36), Polygamist (AOR, 4.4; 95% CI: 1.45, 13.47), history of inheritance (AOR, 5.83; 95% CI: 2.12, 16.4) and history of STI (AOR, 5.57; 95% CI: 2.07, 14.96) were factors associated with precancerous cervical lesion. Conclusion: A significant prevalence of precancerous cervical lesion among women in the rural community is observed. Strategies like awareness creation and screening service at primary health care unit level is required. Measures in preventing to have more wives, wife inheritance, and reducing the number of sexual partners are required.

Willingness for cervical cancer screening and associated factors among HIV positive women on follow-up at Jinka General Hospital, Southern Ethiopia.

Selamawit Gebeyehu, Gurmesa Tura, Bitiya Admassu — Tue, 03 Aug 2021 06:18:48 +0000

Background: Cervical cancer is one of the leading causes of death in women worldwide. Women living with Human Immunodeficiency virus are at higher risk of acquire cervical cancer. Despite the importance of screening, the proportion of willingness for screening among these women is low in Ethiopia. Therefore, this study aimed to determine the magnitude of willingness for cervical cancer screening and its associated factors among women living with HIV.

Methods: A facility-based cross-sectional study was conducted from March 14 to May 8, 2018.341 women were selected by using systematic sampling method among adult HIV positive women attending treatment at Jinka general hospital. The data were collected using an interviewer-administered questionnaire.

Bivariate and multivariable logistic regression analyses were used to determine the presence and the strength of association between dependent and independent variables by using odds ratio with 95% confidence interval.

Results: The status of willingness for cervical cancer screening was 56.9% (95%CI; 51.6%, 62.1%). Women aged 40 years and above (AOR=2.58; 95% CI = 1.21-5.45), having two or less number of children (AOR=2.49; 95% CI =1.3-4.78), having awareness about cervical cancer screening (AOR = 4.85; 95% CI = 2.56-9.17), high perceived susceptibility (AOR=5.02;95%CI=2.74-9.18) and low perceived barrier (AOR=9.87; 95% CI = 5.34-18.31) were found to increase willingness for cervical cancer screening.

Conclusions: In this study, the willingness for cervical cancer screening among HIV positive women was low. Age, number of living children, awareness about cervical cancer screening, perceived barrier and susceptibility were independent factors associated with the willingness of cervical cancer screening. Health care workers and cervical cancer prevention and control programs should create awareness by using different mass media. Health care providers should counsel on the above barrier for willingness to cervical cancer screening.

Prevalence and determinant factors of unintended pregnancy among pregnant women attending antenatal clinics of Shashamane hospitals

Tue, 03 Aug 2021 06:21:39 +0000

ABSTRACT

Background: Unintended pregnancy is one of the measures of quality of reproductive health service success or failure and is defined as a pregnancy that is not wanted and/or not planned at the time of conception. Unintended pregnancy remains a major public health problem in sub-Saharan countries including Ethiopia. Therefore, the main aim of this study was to assess the magnitude and determinants of unintended pregnancy among pregnant women attending antenatal clinics of Shashemene hospitals.

Methods: An institutional-based cross-sectional study was conducted among 380 pregnant women from March 25 to April 30/2019. A systematic random sampling technique was used to select the study participants. The data were collected through a pre-tested interviewer-administered questionnaire and it was entered into EPIdata 3.1 and exported to SPSS 24 for further analysis. Binary and multivariate logistic regression analysis was used to identify significant factors. Variables with P-value < 0.05 were used to declare statistical significance.

Result: The magnitude of unintended pregnancy was 31.1%. Age 35-45 years (AOR=0.2 95% CI; 1.057-0.8), parity ≥3 (AOR= 9.7 95% CI; 2.0-47.7), poor knowledge of family planning (AOR= 2.85 95% CI; 1.54-5.3), being rural residence (AOR = 1.27 95% CI; 2.15-4.5), and low husbands educational level (AOR= 4.34 95%CI; 2.16-9.73) were some of factors which affect unintended pregnancy.

Conclusion: The magnitude of unintended pregnancy is high in the study area. Low educational status of the husband, maternal age, parity, residence, and knowledge of mothers on family planning was the most important determinant factor of unintended pregnancy. Increase timely awareness and utilization of reproductive health care services like modern contraceptives are recommended for reducing the prevalence of unplanned pregnancy.

DETERMINANTS OF PREGNANCY AMONG LATE ADOLESCENTS VISITING PUBLIC HEALTH FACILITIES OF ARBA MINCH TOWN, SOUTHERN ETHIOPIA: A CASE CONTROL STUDY

Tue, 03 Aug 2021 06:23:29 +0000

Background: Adolescent period is characterized by having physical, social, and psychological behaviors that put themselves for different problems like pregnancy. Those pregnancies which occur during the adolescent period result in poor maternal and child health.

Objective: The aim of this study is to identify determinants of pregnancy among late adolescents who visit public health facilities of Arba Minch town, Ethiopia 2019

Methods: An institution-based unmatched case-control study was conducted from Feb 9-Apr 9 2019. Cases were pregnant Adolescents age (15-19 years) who came for delivery, abortion or antenatal care on other hand controls were non-pregnant adolescents age (15-19 years) who visited outpatient department or youth-friendly services for other cases (ruled out by history and HCG pregnancy test). The total sample size was 380 (85 cases and 285 controls) which were randomly selected. Data was collected by using face-to-face interviews and entered into Epi-data version 3.4 then exported to SPSS version-23 for analysis. Multivariable logistic regression was used to assess determinants. Statistically, significance was considered at a p-value ≤ 0.05.

Result: Finding of this study show that family monthly income less than one thousand Ethiopian Birr (AOR=11.11; 95%CI 2.65-46.65), family history of pregnancy before age 19 years (AOR=2.85; 95%CI 1.04-7.79), starting first sex without desire (AOR=2.52; 95%CI1.07-5.93) and poor modern contraceptive methods (AOR=4.84; 95%CI 2.09-11.20) were determinate of adolescents in the study area.

Conclusion: Family income, family history of adolescent pregnancy, starting first sex without desire, and poor modern contraceptive methods were determinants of adolescents’ pregnancy. Therefore, respective stakeholders should develop interventions especially about modern family planning methods for adolescents.

Keywords: Late adolescent pregnancy; Determinants; Arba Minch town public health facilities

A CASE REPORT OF UTERINE MYOMA CAUSING NON-PURPURAL UTERINE INVERSION

Yitbarek Fantahun, Sofanit Haile, Eskinder Kebede , Sisay Teklu — Tue, 03 Aug 2021 06:25:00 +0000

Uterine inversion is a condition where the uterus is inverted downward with prolapse of the fundus into the endometrial cavity and to the cervix. It is broadly classified as puerperal and nonpuerperal based on the cause of the uterine inversion with puerperal uterine inversion being a more common type of inversion. Here is a rare form of non-puerperal uterine inversion with fundal submucous myoma.

Keyword: Haultain’s method, Myoma, Uterine inversion.