The Difficulties Encountered In The Management Of Male Infertility In Nnewi, Nigeria
A. M. E. Nwofor and A. I. Ugezu

SUMMARY

Objective: To determine the aetiological pattern and problems encountered in the treatment of infertile men seen at the Urology Clinic of Nnamdi Azikiwe University Teaching Hospital, Nnewi (NAUTH).align=justify> Patients and Methods: A 5-year review of the records of all cases of male infertility seen at the Urology Clinic of NAUTH between January 1996 and December 2000. Demographic data, presentation, clinical findings, diagnosis, investigation results, treatment and follow up were analyzed.

Results: A total of 46 cases of male infertility were seen during the period. Out of these, 65.2% were primary infertility while 34.8% were secondary. Mean age was 39.4+6.8 years. The commonest aetiological factor was varicocoele (43.5%). Others include testicular atrophy secondary to recurrent torsion (21.7%), erectile dysfunction 19.6%, urethral stricture and hormonal inbalance 6.5% each, and orchitis 2.2%. Traders were the most commonly affected occupational group accounting for 41.35%. Azospermia was seen in 34.8%, oligospermia less than 1 x106/ml in 30.4% and 1-10x106/ml in 17.4% while counts of over 20x106/ml were seen in 13.3%. Treatment depended on the cause. All those who accepted varicocoelectomy showed improvement in count and quality of semen at follow up while only 2.2% achieved pregnancy during the study period. 69.6% were lost to follow up while the longest follow up was 3 years.

Conclusion: V Infertility is a major health problem in Nigeria. Facilities for its investigation and treatment are still mostly unavailable. Impatience and ignorance had led to high drop out rate from treatment and follow up thus making it difficult to evaluate the outcome of treatment. Niger Med J. 2003; Vol 45 (1):

KEY WORDS: Male infertility, treatment difficulties, poor follow up.