Beliefs about children and the psychosocial implications of infertility on individuals seeking assisted fertilization in Ghana

Going through treatment: experiences of women who sought assisted reproductive technology treatment in five selected hospitals in Ghana

Using a qualitative approach, this paper explores the accounts of 30 women who accessed assisted reproductive technology treatment in five fertility hospitals in Ghana. A semi-structured interview guide was used to collect data on women's experiences of the procedure. Findings indicated that most of the women sought ART treatment to save their relationships from collapsing, with pressure and demands from friends and in-laws as key motivating factors. Women complained of emotional imbalance and the high cost of ART treatment. They felt compelled to borrow money from friends, family and banks and, sometimes sold assets to pay for treatment costs. Health consequences such as depression, changes in menstrual flow, weight loss, body pain, breast tenderness, bleeding and disruption to daily activities and sexual life were reported as problems encountered by the women. While study findings are supportive of the inclusion of infertility treatment in the national health insurance scheme, more adequate counselling and education for women undergoing ART treatment is required.

The optimal route of progesterone administration for luteal phase support in a frozen embryo transfer: a systematic review

OBJECTIVE

To investigate the optimal route of progesterone administration for luteal phase support in a frozen embryo transfer.

DESIGN

Systematic review.

PATIENTS

Women undergoing frozen embryo transfer (FET).

INTERVENTIONS

We conducted an extensive database search of Medline (PubMed), Embase, Web of Science, and Cochrane Trials Register using relevant keywords and their combinations to find randomized controlled trials (RCTs) comparing the routes (i.e., oral, vaginal, intramuscular) of progesterone administration for luteal phase support (LPS) in artificial FET.

MAIN OUTCOME MEASURES

Clinical pregnancy, live birth, miscarriage.

RESULTS

Four RCTs with 3245 participants undergoing artificial endometrial preparation (EP) cycles during FET were found to be eligible. Four trials compared vaginal progesterone with intramuscular progesterone and two trials compared vaginal progesterone with oral progesterone. One study favored of vaginal versus oral progesterone for clinical pregnancy rates (RR 0.45, 95% CI 0.22-0.92) and other study favored intramuscular versus vaginal progesterone for clinical pregnancy rates (RR 1.46, 95% CI 1.21-1.76) and live birth rates (RR 1.62, 95% CI 1.28-2.05). Tabulation of overall evidence strength assessment showed low-quality evidence on the basis that for each outcome-comparison pair, there were deficiencies in either directness of outcome measurement or study quality.

CONCLUSION

There was little consensus and evidence was heterogeneous on the optimal route of administration of progesterone for LPS during FET in artificial EP cycles. This warrants more trials, indirect comparisons, and network meta-analyses.

PROPERO NO

CRD42021251017.

Exploring the cultural perspectives and implications of infertility among couples in the Talensi and Nabdam Districts of the upper east region of Ghana

BACKGROUND

Infertility remains a major clinical and social problem, affecting approximately one in every 10 couples. It is a reproductive health condition that is silently experienced with deep repercussions in the essence of self. In Ghana childbearing is considered a social prestige, where the couples are unduly pressurized to bear children for purposes of genealogical continuity.

PURPOSE

This study explored the cultural perspectives and implications among males and females experiencing infertility in the Talensi and Nabdam districts of the Upper East Region of Ghana.

METHODS

This study used an ethnographic design to explore the perspectives of couples on socio-cultural beliefs about infertility on 15 participants made up of 8 male and 7 female couple units. Participants were selected using a purposive sampling technique while semi-structured interviews were used to explore the cultural implications on male and female couple units. The data were analysed using Tesch's method of analysing qualitative data.

RESULTS

Two broad themes and five subthemes emerged from the data analysis regarding the cultural implications of infertility. The major themes and subthemes include: (1) Varying cultural perceptions of infertility (Cultural beliefs and perceptions regarding causes of infertility, cultural consequences of infertility and traditional remedies for infertility), and (2) family dynamics stemming from infertility (abuse from family members, and parenthood as a standard for family inheritance).

CONCLUSIONS

This study adduces evidence of the cultural implications of infertility in rural Ghana. Considering the cultural inclination of most Ghanaian communities, especially the current study setting, it is imperative that policymakers and public health practitioners should consider fertility interventions that are culturally sensitive. Also, culturally sensitive intervention programs that are targeted at increasing the awareness of the rural population on fertility and its treatment should be considered.

Knowledge, Attitude, and Perceptions about In Vitro Fertilization (IVF) among Women of Childbearing Age in Cape Coast, Ghana

Background

Infertility impacts a lot of considerable negative social effects on the lives of infertile partners, especially females, who repeatedly experience the emotional sequelae of childlessness. The study's goal was to assess women of reproductive ages' awareness of IVF treatments, as well as their attitudes and misunderstandings about them in Cape Coast, Ghana.

Methods

A total of 437 reproductive-age women in Cape Coast Metropolis were recruited using a simple random sampling approach for this Cross-Sectional Descriptive study. Data were collected with a semistructured interviewer-administered questionnaire and were analyzed using IBM SPSS version 26.0, and p ≤ 0.05 was considered significant.

Results

The mean age was calculated to be 25.33 ± 0.066 years with a greater proportion, 65.7% within 15–24 years, 76.5% had no or had never had a child before. 93.4% were of the Christian faith, 66.8% were aware of IVF, and 74.8% think IVF offers hope. Although 41.4% believe it is not a natural procedure and 44.6% believe IVF children are normal but not natural. While 72.1% believe the treatment is very costly, and 40.7% believe it is not affordable or accessible. The majority believe IVF kids are legitimate (76.9%), and so should be welcomed by society (86.5%). The overall opinion of IVF service acceptability was 81.7% good. Seventy-two and three percent did not know whether IVF services are available in Cape Coast. Also, 48.1% were aware that IVF may result in pregnancy failure, with fewer than half (43.5%) believing it could be linked to genetic problems in the baby. The majority (60.4%) were willing to use IVF services, and 82.8% will utilize just their husband's sperm technique. While others may not want to undergo any form of IVF technique because they desire to conceive naturally (51.0%) and 22.4% may be unable to pay for it. Educational status and awareness of the availability of IVF services were factors that were significantly associated with their overall good perception of IVF services. Also, age, marital status, number of live children, occupation, educational status, awareness, and their overall perception were factors that are significantly associated with their preparedness to utilize IVF services.

Conclusion

Overall, women's opinions of IVF and their readiness to use them were favorable, and they think it offers hope for their condition since they were well-informed about its forms and that infertility may be a result of several factors, all of which may need IVF services. It does not matter if it is difficult to obtain, expensive, or unavailable. It is recommended that the government collaborates with healthcare providers to investigate ways through the mass media in the drive to clear the misconceptions and improve the public understanding of the IVF procedure towards its utilization, thereby reducing the burden of childlessness and the resulting psychological disorders among couples, this has implications for joyful homes and societal growth.