The etiology of infertility in the western region of Libya: An investigation of medical records

Abstract

Aim: The aim of this study is to investigate the etiology of infertility in couples seeking medical help from the Infertility Clinics and gynecological departments in hospitals in Western Libya. Patients and Methods: Data were collected directly from patients' medical records. However, additional data were collected through interviews. Results: The total number of couples recruited was 135. Men (mean ± standard deviation of age = 41.7 ± 7.0 years) were significantly older than women (35.2 ± 6.5 years) (P = 0.001). Women were more likely to marry younger than men (mean difference = 6.5 years, 95% confidence interval [CI] =5.1–7.8 years) and the duration of all participant's marriages before the interviews was 9.0 ± 5.0 years. The causes of fertility were as follows: 33 (24.4%) (95% CI 17.16–31.64) cases were due to a female factor, 92 (68.1%) (95% CI = 60.24–75.96) cases were due to a male factor with 6 (4.4%) (95% CI 0.94–7.86) cases of combined male and female factor and 4 (3%) (95% CI = 0.12–5.88) cases without explained cause. Out of all patients, only 13 (4.8%) (95% CI = 2.25–7.35) were cases of secondary infertility and 257 (95.2%) (95% CI = 92.65–97.75) were cases of primary infertility. In females, the most common causes of infertility were ovulation disorders with 40 (23.4%) (95% CI = 17.05%–29.75%), polycystic ovary syndrome with 23 (13.5%) (95% CI = 8.38%–18.62%), irregular or no menstruation with 19 (11.1%) (95% CI = 6.39%–15.81%). The most frequent findings in males were 76 cases (31.0%) (95% CI = 25.21%–36.79%) asthenospermia, 75 cases (30.6%) (95% CI = 24.83%–36.37%) showing teratospermia and 56 (22.9%) (95% CI = 17.64%–28.16%) with oligospermia. Conclusions: Infertility due to male factor in Libya (approximately 70%), was very high compared to data from other regions of the world. Infertility due to the female factor is comparable to other regions of the world. The main cause for female factor infertility was ovulation disorders. Further research of infertility in other parts of the Middle Eastern and North African region is needed. This research must combine epidemiological, medical, and social investigations to find the main causes of infertility in the region.