Success Rate and Time-To-Live Birth of Fertility Treatments among Couples Attending Fertility Centers in Addis Ababa, Ethiopia.
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Date
2024-06
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Addis Ababa University
Abstract
Background: Despite impacting one in six individuals globally, infertility remains a neglected
public health issue, particularly in low- and middle-income countries like Ethiopia. The
emergence of local fertility centers offers promising alternatives to costly outgoing travel, crucial
data on treatment success rates remains scarce.
Objective: To assess the treatment success rate and time to live birth of infertility treatments
among couples attending public and private fertility centers in Addis Ababa, Ethiopia.
Methods: A cross-sectional study using data from patient chart was conducted among 411
couples from St. Paul’s Hospital Millennium Medical College and Ethio fertility and IVF center
in Addis Ababa. A simple random sampling technique was used to select samples from
participants who started fertility treatments from March 2021 to February 2023. Data was
collected by three nurses who work at the facilities using the data abstraction format and
questionnaire under close supervision. Descriptive statistics and binary logistic regression
analysis were used to assess the success rates of treatments in terms of clinical pregnancy, and
Kaplan-Meier, Life Table, log-rank test and Cox regression were used to analyze the data on the
time-to-live birth.
Results: Among the 411 couples who took fertility treatments, 47% and 33.1% were able to
achieve clinical pregnancy and live birth, respectively. In-vitro fertilization has 39.3% success
rate per cycle whereas, Intrauterine insemination registered 12% success per cycle. In terms of
live birth, In-vitro fertilization procedure also achieved highest hazard of live birth compared to
Intrauterine insemination. Woman’s age ≥35, increased duration of infertility, and the presence of
Tubal factor infertility were negative predictors of clinical pregnancy rate while, Antral follicle
count ≥5, increase in number of treatment cycles, increase in endometrial thickness and increase
in number of frozen cycle of IVF/ICSI indicated a higher chance of treatment success. Age ≥35,
longer duration of infertility, frozen cycle type, AFC <5 and fewer number of treatment cycles
had negative influence on live birth compared to their counter others.
Conclusion: Younger women and couples with repeated treatment cycles have better outcomes
at clinical pregnancy and live birth. Assisted reproductive technology in Addis Ababa reach
internationally comparable levels. Early intervention of infertility and repeated treatment cycles
should be made available for all parts of Ethiopia and public awareness should be created
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Keywords
In-vitro fertilization, Clinical pregnancy, Assisted reproductive technology, Infertility, Live birth, Ethiopia