The causes and pattern of presentation of male factor infertility as seen at Kenyatta National Hospital.

Abstract

BACKGROUND: Infertility is defined as the incapability of attaining a pregnancy after one year of regular unprotected intercourse. A considerable body of literature on the causes of female infertility exists, but there is a deficit of data on male factor infertility. OBJECTIVE: To identify and describe the causes and pattern of presentation of male factor infertility at Kenyatta National Hospital. METHODOLOGY: This was a cross sectional study conducted among patients with male factor infertility that underwent treatment at the Kenyatta National Hospital urological, gynaecological and the doctor’s plaza clinics. Selection of participants was done in a nonrandomized consecutive sampling of eligible patients until the desired sample size was achieved. Informed consent was obtained from all the participants. A structured questionnaire was administered to the participants who consented to participate in the study. The collected data was uploaded to a password protected excel sheet for coding and analysis before analysis using SPSS version 22.0 software. Descriptive statistics for socio demographics such as age and smoking history were presented as proportions using pie charts and tables. RESULTS: This study found 60.5% of male factor infertility to be due to unexplained factors, 31.6% due to varicoceles, 2.6% due to congenital factors and 5.2% due to ejaculatory duct obstruction. The mean age for the study participants was 34.7 years (standard deviation - 4.8). Most patients did not have clinical risk factors attributed towards male factor infertility. 71.5% of subjects reported a frequency of having sexual intercourse at least once weekly, 26.3% reported having sexual intercourse at least twice a month whereas only 2.6% reported of having sexual intercourse less than twice a month. Semen analysis was done on all the subjects who were included in the study. oligozoospermia was found to be the commonest abnormality at 36.8%, azoospermia at 28.9%, asthenozoospermia at 8% and a combination of oligozoospermia and asthenozoospermia at 13.2%. CONCLUSION: Male factor infertility is a common and distressing condition to a patient. Thus it is important to invest in diagnostic and treatment technologies locally to be able tackle this disease. Despite some limitations, the study provides a basis for further scientific research on male factor infertility in our setup.