In-Vitro Fertilization: Awareness and perception among infertile women at the Jos University Teaching Hospital

Background: The prevalence of infertility is high in the developing world, sub-Saharan Africa inclusive with its attendant medical and social consequences. Tubal factor and male factor are responsible for the majority of cases of infertility in this environment. In-Vitro fertilization (IVF) is the treatment of choice for these cases. Though the services are available in some parts of the country including Jos, the uptake appears to be low. We sought to assess the awareness and willingness to accept IVF services among infertile women inJos University Teaching Hospital. Method: A cross-sectional descriptive study involving 149 patients from the Gynaecological clinic of the Jos University Teaching Hospital was carried out. Data were obtained using a pretested questionnaire and analyzed using SPSS version 21.0. Results: The mean age of the respondents was 30+6 years. Only 45.6% had heard about IVF. The information they had on IVF was inaccurate in 52.9% of respondents. The majority (77.9%) of the respondents had no idea of the success rate of IVF but believed the process guaranteed pregnancy. Most respondents (74.5%) preferred to have multiple pregnancies if given a choice, however, the majority (72.7%) were unaware of the complications associated with multiple pregnancies. Conclusion: Efforts to improve the awareness about IVF should be adopted to increase the uptake of the IVF services. Keywords: IVF, awareness of IVF, infertility, Nigeri

A Review of hysteroscopy in a private hospital in Jos, Nigeria

Background: Examination of the uterine cavity is an imperative gynaecology for the detection and treatment of intrauterine abnormalities. Hysteroscopy is considered to be the gold standard for this purpose Identification and subsequent treatment of intrauterine leisons may improve pregnancy rates in Invitro fertilization(IVF).Methods: Medical records of patients who had hysteroscopy between May 2016 and April 2017 at Kauna Specialist Hospital were analysed. Indications for hysteroscopy, findings and complications were noted.Results: A total of 82 hysteroscopies were performed during the period under review. The commonest indication was preparation for IVF in infertile patients (58.1%). Other indications included infertility (27.2%), menorrhagia (9.9%) and hypomenorrhoea (2.4%). Intrauterine abnormalities were detected in 59.3% Patients. Intrauterine adhesions were found in 30.9% of the patients . Endometrial polyps (13.7%), fibroids(4.9%) and irregular endometrial lining(4.9%) were also observed. A large proportion (42.7%) of patients who had recurrent IVF failure had intrauterine abnormalities.Conclusion: Hysteroscopy is an invaluable tool in the detection and treatment of intrauterine leisons. Its wider use is advocated in gynaecological practice in Nigeria.Key words: Hysteroscopy; Infertility; In Vitro fertilization, intrauterine abnormalitie

Profile of HIV voluntary counseling and testing seropositive acceptors in Niger-Delta, Nigeria

Sub-Saharan Africa is most heavily affected by human immunodeficiency virus (HIV) infection worldwide. The infection is more commonly observed amongst vulnerable populations. The objective was to determine the profile of seropositive acceptors of HIV voluntary counseling and testing in Niger-Delta, Nigeria. Medical records of voluntary counseling and testing (VCT) acceptors at the Sacred Heart Hospital Obudu, Cross-River State, Nigeria, from January to July 2010 were reviewed. HIV antibody screening was done using two rapid ELISA tests. A total of 1269 VCT acceptors were screened for HIV antibodies out of which 134 (10.6%) tested positive. The age group 20-29 year old was more affected (41.0%). Average age of seropositive acceptors was however 31.21±8.8 years. Most of them 80 (59.7%) were females, married 61 (45.5%) and either had none or low level of formal education (61.2%). Traders constituted 25.4%, students 24.6%, farmers 20.9% among others. More females were married than the males (50.0% vs 38.9%) (P>0.05). There were more educated females than males (P>0.05). Those who had formal education were more likely to be either gainfully employed or seeking for one (P<0.001). HIV positivity was observed mostly among married, female adolescence/ young adult with either none or low level of formal education and engaged in commercial activities. Sustaining efforts towards women education, economic empowerment, and gender equity, modification of risky social lifestyle and VCT for HIV will be helpful in reducing HIV infection among the vulnerable groups

Awareness of antimullerian hormone assay and its relevance in in-vitro fertilization among laboratory scientists

Background: infertility is a challenging medical disorder affecting 1 in every 6 couples. In-Vitro fertilization(IVF) offers hope for couples to actualize their dreams of procreation. Success with IVF is determined by several factors including ovarian reserve which can be determined by measuring serum levels of Antimullerian hormone (AMH).We evaluated the level of awareness of laboratory personnel on AMH and IVF in our environment.Methods: A self-administered questionnaire was administered to laboratory scientists at an annual conference of laboratory scientists.Result: A total of 174 questionnaires to 87 males and 87 females. Most of the participants were classified as senior staff (44.8%) while 8.6% were administrators/ directors. Our study revealed that 80.5% of the respondents had never heard of AMH although 70.1% had knowledge of IVF. The least commonly requested laboratory test for infertility evaluation was AMH (9.1%) while semen analysis was the commonest test (28.7%). Most respondents were of the opinion (98%) that both male and females should be evaluated when managing infertile couples.Conclusion: The awareness of AMH and its use in evaluating infertile patients is low among scientists in our environment. The educational system should be involved in revising curriculums especially in areas of current methods for successful IVF treatment.Key words: Antimullerian hormone, In Vitro Fertilization, Infertility, Laboratory scientis

Audit of antenatal services in primary healthcare centres in Jos, Nigeria

Introduction: Maternal mortality remains a big challenge in developing countries including Nigeria where the figures are amongst the highest in the world. The Nigerian government's response in providing primary healthcare centres (PHCs) in all local government areas is commendable but access to quality antenatal care is still poor. The high proportion of maternal deaths resulting from late referrals from PHC's to the Jos University Teaching Hospital (JUTH), prompted this study to audit antenatal services in PHC's in Jos. Methods: Six of the 12 PHC's in Jos were randomly sampled and 425 consecutive antenatal clinic attendees were recruited for the study. In each case, the client's records were scrutinized and a detailed history and physical examination was conducted. Details of personal data and of antenatal care provided were tabulated and analyzed using frequencies. Results: The results showed that 35.5% of pregnant women receiving antenatal care at PHCs in the Jos area were clients with high-risk pregnancies. Over two-thirds of the pregnant women received antenatal care in the PHCs without blood pressure surveillance. Maternal weight was regularly checked in 78.1% (332/425) but height was not recorded in any woman. Sickling test/genotype and VDRL were not done and no client received malaria prophylaxis. Conclusion: The study showed that the standard of antenatal care offered in PHCs in Jos fell short of the required level and represents a missed opportunity to impact on the poor maternal and perinatal health statistics in the area. Keywords: antenatal care, standard of care, audit, Nigeria Tropical Journal of Obstetrics and GynaecologyVol. 22(2) 2005: 147-15

Acceptability of Vasectomy in Jos, Northern Nigeria

Objective: The paper reports on the ten cases of vasectomy performed in our institution over a sixteen year period. Design: It is a retrospective study of clients\' case-notes from January 1985 to December 2000. Setting: Jos University Teaching Hospital, Plateau State, Nigeria. Results: During the 16 year period, a total of ten males volunteered to have vasectomy performed on them in contrast to 3585 females who had surgical contraception via minilaparotomy during the same period, giving an incidence of 0.28%. Their age range was 41-62 years, range of children per family of 3-14, with 3-11 children alive at the time of the procedure. They were in stable marriages and chose vasectomy because they had completed their family sizes. Compilations attributed to the procedure were minor and resolved with treatment. Conclusion: Vasectomy even though safe, simple and effective is not readily acceptable as a method of fertility control in our institution and this part of Nigeria. Key Words: vasectomy, contraception, safe, effective. [Trop J Obstet Gynaecol, 2004;21:56-57

Combining the IADPSG criteria with the WHO diagnostic criteria for gestational diabetes mellitus optimizes predictability of adverse pregnancy outcome

Background: Gestational diabetes mellitus (GDM) is associated with adverse pregnancy outcomes, yet there are no universally accepted diagnostic criteria for GDM. The International Association of Diabetes in Pregnancy Study Group (IADPSG) and World Health Organization′s (WHO) diagnostic criteria are commonly used criteria, although clinical outcome data of diagnostic performance of these diagnostic criteria are limited. This study examines the IADPSG and WHO criteria for predicting adverse pregnancy outcomes. Materials and Methods: This longitudinal study involved 130 pregnant women who underwent Oral Glucose Tolerance Testing (OGTT) during 24-32 weeks of gestation. Fasting, 1-hour and 2-hour glucose were measured. Participants were classified as GDM and non-GDM women based on the IADPSG and WHO diagnostic criteria. Five pregnancy outcomes were observed, namely, pre-eclampsia, shoulder dystocia or birth injury, birth weight ≥4.0 kg, clinical neonatal hypoglycaemia and birth asphyxia. Results: Twenty-eight participants (21.5%) had GDM by the IADPSG criteria (GDM IADPSG ) and 21 (16.2%) women had GDM by the WHO criteria (GDM WHO ). Only 15 women (11.5%) met the criteria for GDM by both criteria. The association of GDM with macrosomia was stronger in GDM WHO women [Odds ratio (OR) =13.1, 95% confidence interval (CI) = 3.4-50.6] compared to the GDM IADPSG women (OR = 5.3, 95% CI 1.5-18.9). Macrosomia or at least one adverse outcome were more likely in GDM patients who met the diagnostic criteria by both the IADPSG and WHO criteria (P = 0.001). Conclusion: A diagnosis of GDM that meets both the WHO and IADPSG criteria provides stronger prediction for adverse pregnancy outcome than a diagnosis that meets only WHO or IADPSG criteria

Gestational age at booking for Antenatal Care and the pregnancy outcome at Faith Alive Hospital, Jos, Nigeria

Background: Early initiation of antenatal care is believed to improve maternal and foetal outcome. We sought to ascertain gestational age at booking and the outcome of these pregnancies at a faith based hospital in northern Nigeria. Methods: A retrospective descriptive study of patients who booked for antenatal care at the Faith Alive Hospital, Jos, st st Nigeria between 1 January, 2010 to 31 December, 2017 was done. Information regarding demographics, gestational age at booking and outcome of these pregnancies were analyzed. Result: During the study period, 3739 women registered for antenatal care. Majority of women were 20-24years (n= 1252 , 33.5 %) while The mean age was 28 ± 4years Of these women, 96.2% were married , 75.2% were Christians, 43.8% had secondary level of education and 41.2% were traders. st Furthermore, 23.2% of the clients booked in the 1 trimester in 2010, decreased to 17.3% in 2012 but progressively increased to 35.2% , 40.2% and 53.4% in 2014, 2015 and 2017 respectively. There was a significant statistical association between parity, marital status and educational status with late booking for antenatal care. Clients who booked late for antenatal care had poorer neonatal outcomes (low birth weight, still births and birth asphyxia) compared to those who booked early. Conclusion: Late initiation of antenatal care is common in our environment and associated with poorer neonatal outcomes.&nbsp; Nonetheless, a progressive improvement in early bookings was noticed with improved pregnancy outcome. Key Words: Gestational age, booking, pregnancy outcome, Faith Alive, Jo