Laboratory Evaluation of Ghanaian Women Attending Fertility Clinic at Lister Hospital and Fertility Centre, Accra-Ghana

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Over 70 million couples suffer from infertility worldwide and the majority of these couples can be found in developing countries. In comparison to the Western world the negative consequences of childlessness are experienced to a greater degree in developing countries. Sexually transmitted diseases and hormonal imbalances are the most common cause of infertility in developing countries, and this can be treated with assisted reproductive technologies (ART). The unavailability or the expensiveness of new reproductive technologies in developing countries is a problem. This study aims to determine if there is any significant difference in the haematological and hormonal profiles of infertile and fertile women and also the prevalence of sexually transmitted infections, toxoplasmosis and rubella immunity in infertile women. Three hundred and forty coagulated and non coagulated blood and high vaginal swab samples were collected from women within the age range of 24yrs to 58yrs attending infertility (300) and post natal (40) clinics at Lister Hospital and Fertility centre, Accra in Ghana. The enzyme-linked immune-sorbent assay (ELISA) method was used in analyzing the fertility hormones using the NoviWell™ assay kits (HySkill Diagnostics, Bahlingen, Germany) and the serological tests using the Orgenics® assay kits (Inverness Medical Innovations Group, Yavne, Israel).The haematological parameters were done using the QBC® Autoread Plus haematological analyzer (QBC Diagnostic Incorporated, Philipsburg, Pennsylvania, USA) and the gonorrhoea infection test using the Gram’s staining technique in Medical Laboratory Manual for Tropical Countries (Tropical Health Technology, Doddington, United Kingdom). The hormonal profile in the infertile women were higher: testosterone (1.86 ± 0.24) , follicle stimulating hormone (11.51 ± 0.84) and prolactin (22.36 ± 0.67) than the fertile subjects: testosterone (0.48 ± 0.04) , follicle stimulating hormone (6.99 ± 0.27) and prolactin (12.05 ± 0.62). From this study, the prevalence of toxoplasma gondii infection was similar in both fertile (27.5%) and infertile (20.0%) women and this increased with age. There was no significant difference in the prevalence of non-immunity to rubella among infertile (26%) and fertile (30%) subjects in this study. Though the prevalence of sexually transmitted infections in the infertile women was higher, it did not reach statistically significant level. The hormonal profile and the prevalence of Toxoplasma gondii in infertile women were higher comparatively to their fertile counterpart.
A Thesis Submitted in Fulfillment Of the Requirements for the Degree Of MASTER OF PHILOSOPHY in the Department of Molecular Medicine,School of Medical Sciences, 2009.