Clinical Correlates of Unexplained Infertility in Southeastern Nigeria

Context: In the absence of any obvious aetiological factor, a couple is said to have unexplained infertility. It is desirable to identify factors associated with unexplained infertility in this environment and to ascertain if there is a causal relationship between infertility and uterine leiomyomata. Objective: The study is aimed at identifying clinical factors associated with unexplained infertility and determining if there is any difference in the prevalence of uterine fibroids between women for whom a cause of infertility is identifiable and those with unexplained infertility. Study Methods: The records of infertility patients from our clinics at Nnewi and Awka were examined for the identifiable causes of infertility and the presence of uterine fibroids. Results: The cause of infertility was obvious in 279 (89%) of the 314 couples that completed their evaluation while 35 couples (11%) had unexplained infertility. The type of infertility (primary or secondary) had no influence on whether the aetiology is identified or not. However, increasing parity and duration of infertility is significantly associated with an identifiable aetiology. Uterine leiomyomata were present in 61 (19%) of the 314 infertile women studied. Fifty (18%) of the women who had an identifiable cause for their infertility had fibroids compared to 11 (31%) of the women with unexplained infertility (P < 0.005). Conclusion: Unexplained infertility is less common with increasing parity and duration of infertility. Uterine fibroids are more common in women with unexplained infertility. Myomectomy in these women may offer a greater chance of achieving conception. Key Words: Infertility, Uterine Leiomyomata, Myomectomy. [Trop J Obstet Gynaecol, 2002, 19: 8-11]