Obstetrics and Gynecology

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Browsing Obstetrics and Gynecology by Subject "Ethiopia"

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    A Four- Year Survival Outcome of Ovarian Cancer Patients at Tikur Ambessa Specialized Hospital, Addis Ababa, Ethiopia.
    (Addis Ababa Uinverstiy, 2026) Dr.Motuma Gutu; Dr Yirgu G/Hiwot,; Dr Dawit Dessalegn,
    Introduction: Ovarian cancer poses a major public health issue in Ethiopia, yet its clinical characteristics within the local population are not well-studied. Thus, it is important to understand the ovarian cancer clinical features and survival outcomes in Ethiopia to get crucial insights into the disease's progression. It also helps to guide targeted interventions for early disease detection, treatment, and patient care strategies. Objective of the study: To investigate the survival outcomes of ovarian cancer patients in Addis Ababa, Ethiopia. Methodology: Retrospective cohort study was done on consecutive patients treated for ovarian cancer from 2020-2023 in TASH. A demographic and clinical information were collected using structured questionnaire. Kaplan-Meier survival curves were generated to assess survival outcomes, and Cox proportional hazards regression was used to identify prognostic factors associated with survival. Result: The ovarian cancer median age of diagnosis was 45 yrs (with IQR of 38 - 55yrs) and ranging from 14 to 80 yrs. The median duration of symptoms was 3 months (with IQR of 2-6 month). The histologic distribution shows epithelial tumors of 80.7% including borderline tumors 6.4%, GCT 5.5% and SCST 11%. The median OS for epithelial ovarian cancer was 36.6 months. The first, second- and third-year epithelial ovarian cancer over-all survival was 85.8%, 67.3% and 47.5% respectively. The progression free survivals (PFS) at 1st and 2nd year were 67.8% and 39.6% respectively with median progression free survival of 24.5 months. In cox proportional hazard regression, presence of residual disease (HR = 3.19; 95% CI: [1.22-8.34]; p = 0.018) and those patients treated with only chemotherapy as primary treatment (HR = 4.48; 95% CI: [1.80-11.13]; p = 0.001) were statistically associated with overall survival. Patients treated with interval debulking surgery were associated with shorter progression free interval as compared to PDS (HR= 2.11; 95% CI: [1.06- 4.21]; p = 0.033). Conclusion: Collectively, these findings illustrate both strengths and critical gaps in ovarian cancer care delivery. The high primary surgical rate is a positive indicator of institutional capacity, yet frequent distant recurrences, and very limited secondary surgical intervention point to opportunities for improvement.
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    Perspectives of Obstetricians and Gynecologists in Ethiopia Towards Female Sexual.
    (Addis Ababa Uinverstiy, 2026) Dr. Medina Barsenga; Dr. Endalkachew Mekonen; Dr. Salih Hassen
    Background: Female sexual dysfunction (FSD) is a common yet often neglected health problem in Ethiopia. Although obstetricians and gynecologists are the primary providers of sexual and reproductive healthcare, their perspectives on FSD have not previously been assessed. Objective: To assess the knowledge, attitudes, and clinical practices regarding female sexual dysfunction and to identify factors associated with clinical practice among obstetricians and gynecologists in Ethiopia in 2025. Methods: An analytic, nationwide cross-sectional study was conducted among 245 obstetricians and gynecologists recruited through convenience sampling via professional networks and social media platforms. Data were collected using a structured, self-administered questionnaire. The data were summarized using frequencies and percentages, medians and interquartile ranges, and graphical presentations. To identify factors associated with good practice, binary logistic regression analysis was performed at p < 0.05, and results were reported using adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Results: Out of 245 participants, 40.8% demonstrated adequate knowledge and 41.2% had favorable attitudes, but only 10.2% exhibited good clinical practice, while 61.2% were categorized as having poor practice. Most specialists correctly identified core types of FSD, such as decreased sexual desire (96.3%), but fewer than half were aware of standardized assessment tools such as the Female Sexual Function Index (46.1%). The most prominent barriers reported were lack of formal training (79.6%), absence of clinical guidelines (64.5%), and cultural or religious factors (59.6%). In multivariate analysis, factors significantly associated with good practice included more than 5 years of professional experience (AOR = 2.59, 95% CI: 1.25–5.37, p = 0.010), formal sexual and reproductive health (SRH) training specially on FSD (AOR = 10.01, 95% CI: 2.40–41.78, p = 0.002), adequate knowledge (AOR = 5.80, 95% CI: 3.01–11.19, p < 0.0001), and favorable attitude (AOR = 4.11, 95% CI: 2.14–7.87, p < 0.0001). Conclusion: Ethiopian obstetricians and gynecologists demonstrate moderate knowledge and generally favorable attitudes toward female sexual dysfunction; however, clinical practice remains limited. The tenfold increase in good practice among trained providers, together with the high proportion of specialists identifying lack of training as a major barrier, highlights an ix important opportunity for improvement through targeted training and supportive policies that strengthen clinicians‟ skills and translate willingness into effective clinical practice.
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    Prevalence, patterns and Treatment outcomes of abnormal semen parameters among infertile couples in Ethiopia: A Four-Year Retrospective study.
    (Addis Ababa Uinverstiy, 2026) Dr. Nuredin Awel; Dr. Mahlet Yigeremu; Dr. Eyasu Mesfin
    Background: Infertility is a substantial public health burden in sub-Saharan Africa, yet evidence on assisted reproductive technology (ART) outcomes, particularly those related to male factor infertility, remains limited in Ethiopia. Semen analysis is a cornerstone to male fertility assessment; however, its prognostic significance for treatment success with intrauterine insemination (IUI) or intracytoplasmic sperm injection (ICSI) in low-resource settings is not well established. Despite expanding access to ART, data on the prevalence, patterns, and clinical relevance of abnormal semen parameters in Ethiopia are scarce. This study provides the first large-scale analysis of semen profiles and their association with ART outcomes among infertile couples in Ethiopia. Objective: This study aimed at describing the prevalence and patterns of abnormal semen parameters and determining their association with fertility treatment outcomes between IUI and ICSI among infertile couples undergoing first-cycle ART at two private fertility centers in Addis Ababa, Ethiopia. between July 2021 and June 2025. Methods: A four-year retrospective cross-sectional study was conducted among 1,242 consecutive infertile couples who underwent their first ART cycle (IUI or ICSI) between July 2021 and June 2025. Data were extracted from semen analysis records and treatment outcome registries, with semen analysis standardized per WHO 2021 criteria. The primary outcome was clinical pregnancy. Data were analyzed using SPSS version 26. Descriptive statistics were used to assess prevalence and patterns of semen abnormalities. Associations between semen parameters, reproductive characteristics, and clinical pregnancy were evaluated using chi-square tests and multivariable binary logistic regression. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, with statistical significance set at p < 0.05. Results: The mean age of male partners was 40.07 ± 7.78 years, while female partners had a mean age of 34.43 ± 11.69 years. Primary infertility accounted for 64.1% of couples where as Secondary infertility comprised 35.9%. Abnormal semen parameters were highly prevalent, observed in 55.6% (691/1242) of couples with a clinical pregnancy rate of (n=93, 13.5%). The most common isolated abnormalities were suboptimal motility (n=404, 32.5%), suboptimal count (n=347, 27.9%), and atypical morphology (n=221, 17.8%). Azoospermia (0 sperm/mL 11 accounted for n=12, with a prevalence of 1.0% of all men. During the study period treatment distribution was, 685 couples (55.2%) underwent IUI and 557 (44.8%) underwent IVF/ICSI, with corresponding clinical pregnancy rates of 7.7% and 19.0% respectively, yielding an overall clinical pregnancy rate of 12.8% (95% CI: 11.0–14.7%). In multivariable analysis, after adjustment for covariates, abnormal semen parameters were not independently predictive of clinical pregnancy. However, female age ≥35 years was associated with a 56% reduction in the odds of pregnancy compared to age <30 (AOR = 0.44, 95% CI: 0.27–0.74, p = 0.002). IVF/ICSI treatment conferred 3.65 times higher odds of success than IUI (AOR = 3.65, 95% CI: 2.31– 5.78, p < 0.001). Conclusion: More than half of infertile men presenting to private fertility centers in Ethiopia have at least one abnormal semen parameter. However, clinical pregnancy outcomes were primarily influenced by female age and treatment modality rather than semen abnormalities per se. The findings from this study suggest that semen analysis categories alone have limited prognostic role for predicting ART success in this setting. Recommendation: Rather than depending just on semen parameter classifications, clinical counseling and treatment selection for IUI or ICSI should take a holistic, couple-centered approach that gives priority to female age and the overall clinical context. Prospective research is necessary to improve evidence-based classification of infertile couples receiving ART and to better understand the prognostic role of semen abnormalities in ART outcomes.