Knowledge on the risk factors and preventive measures of infertility in female adults aged

18-50years At The Laquintinie Hospital Douala

CHAPTER ONE

INTRODUCTION

Infertility is a disease of etiologies, which can affect both men and women of every ethnic group

and race around the world. World Health Organization (2011) identified infertility as a disease of

the reproductive system defined by the failure of a woman under 35 years of age to achieve a

clinical pregnancy after 12 months of regular unprotected sexual intercourse with exceptions of

other reasons such as breastfeeding or postpartum amenorrhea. Though it is rarely considered a

health issue of serious concern, infertility can lead to distress and depression, as well as

discrimination and ostracism in certain cultures. An estimated 48.5 million couples worldwide

were infertile in 2010 (Hornstein, 2018). According to the Centers for Disease Control and

Prevention CDC, approximately 6% of married women of reproductive age are infertile and

approximately 12% of reproductive age women, regardless of marital status, have impaired

fecundity in the United States of America [USA]. (Shapiro et al, 2017) In most society especially

in Africa, a man’s wealth is measured, in part, by the number of children he has. In indigenous

African society, children are important as farm workers and as a source of support for their

parents in old age. Consequently, a wife’s value to her husband is determined by her ability to

bear healthy children. A wife may be deserted or divorced summarily for her inability to bear

children, even if the husband is the partner responsible for the infertility problem. This high

premium placed on child bearing in the African context is captured in the husband is the partner

responsible for the infertility problem. This high premium placed on child bearing in the African

context is captured in the following Yoruba adage, which says that “children are the cloth of the

body, without children you are naked” (WHO, 2011).

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 Knowledge on the risk factors and preventive measures of infertility in female adults aged
18-50years At The Laquintinie Hospital Douala

Infertility is a common problem worldwide as current estimates show that this problem affects

10-15 percent of couples. Available evidence suggests that the prevalence of infertility is on the

increase in many parts of sub-Saharan Africa (FOS/UNICEF 2000).

In fact, estimates show that male factor infertility is involved in up to 30 percent of couples

seeking investigations and treatment globally (Lewis, 1985).The increasing prevalence of

infertility is closely linked to the rising incidence of sexually transmitted infections and

complication of unsafe abortions and unclean deliveries. In most part of the world, mid and late

adolescence is the time for experimentation and risk taking with little regard for possible

consequences. The sexual behaviour exposes the youth to the risk of sexually transmitted

organisms that can cause pelvic inflammatory diseases leading to infertility. Drug exposure,

alcoholism, and smoking have all been implicated to alter sperm production and function and so

affect fertility especially in men. civilizations to overcome Many factors have been implicated in

the aetiology of infertility. The cause of infertility can be in the male or in the female partners or

even in both partners. The male contribution to infertility is often down Infertility places a huge

psychological burden on infertile couples, especially for women. Women are verbally or

physically abused in their own homes, deprived of their inheritance, sent back to their parents,

ostracized, looked down upon by society, or even have their marriage dissolved or terminated if

they are unable to conceive. Greater knowledge of the factors affecting fertility may help to

decrease the incidence of infertility by allowing couples to avoid certain risk factors. Moreover,

Adebayo (2019) observed that the misconceptions regarding the causes of infertility have often

resulted in a great deal of social and psychological pressures,gender bias and discrimination,

inappropriate interventions and financial wastages.The purpose of study was to find out what

women of reproductive age attending fertility clinics know about the

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 Knowledge on the risk factors and preventive measures of infertility in female adults aged
18-50years At The Laquintinie Hospital Douala

1.1 RESEARCH STATEMENT OF PROBLEM

The increasing prevalence of infertility is closely linked to the rising incidence of sexually

transmitted infections and complication of unsafe abortions and unclean deliveries. In most

part of the world, mid and late adolescence is the time for experimentation and risk taking

with little regard for possible consequences. The sexual behaviour exposes the youth to the

risk of sexually transmitted organisms that can cause pelvic inflammatory diseases leading to

infertility. Drug exposure, alcoholism, and smoking have all been implicated to alter sperm

production and function and so affect fertility especially in men. civilizations to overcome

Many factors have been implicated in the aetiology of infertility. The cause of infertility can

be in the male or in the female partners or even in both partners. The male contribution to

infertility is often down Infertility places a huge psychological burden on infertile couples,

especially for women. Women are verbally or physically abused in their own homes,

deprived of their inheritance, sent back psychological burden on infertile couples, especially

for women. Women are verbally or physically abused in their own homes, deprived of their

inheritance, sent back to their parents, ostracized, looked down upon by society, or even have

their marriage dissolved or terminated if they are unable to conceive. Greater knowledge of

the factors affecting fertility may help to decrease the incidence of infertility by allowing

couples to avoid certain risk factors. Moreover, Adebayo (2019) observed that the

misconceptions regarding the causes of infertility have often resulted in a great deal of social

and psychological pressures, gender bias and discrimination, inappropriate interventions and

financial wastages.

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 Knowledge on the risk factors and preventive measures of infertility in female adults aged
18-50years At The Laquintinie Hospital Douala

1.2

1.3 RESEARCH QUESTION

1.3.1 GENERAL RESEARCH QUESTION

What knowledge does female adults aged 18-50 years have on the risk factors and prevention of

infertility

1.3.2 SPECIFIC RESEARCH QUESTION

 What knowledge dose female adults have on infertility at Laquintini Hospital Douala?

What are the risk factors associated to infertility in female adults at the Laquintini Hospital

Douala?

Which are the measures of prevention of infertilily in female adults.

1.4 RESEARCH HYPOTHESIS

1.4.1 NULL HYPOTHESIS

There is an increased prevalence of infertility among female adults at the Laquintini Hospital

Douala

1.4.2 ALTERNATIVE HYPOTHESIS

There is a decreased prevalence of infertility among female adults at the Laquintini Hospital

Douala

1.5 RESEARCH OBJECTIVES

1.5.1 GENERAL OBJECTIVES

To determine the prevalence and associating factors of infertility among female adults at the

Laquintini Hospital Douala

1.5.2 SPECIFIC OBJECTIVES

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 Knowledge on the risk factors and preventive measures of infertility in female adults aged
18-50years At The Laquintinie Hospital Douala

 To determine the prevalence of infertility among female adults at the Laquintini Hospital

Douala

 To determine the associating risk factors of infertility among female adult at the

Laquintini Hospital Douala

1.6 SCOPE OF STUDY

It will last for two months the from the 1st of April to the 31st of May 2024

1.7 SIGNIFICANCE OF THE STUDY

This study will take approximately 2months with the identification of research place

interest and submission of research form provided by the institution. It will end by data

collection, write up and presentation of result. This work will involve all female adult at

Laquintini Hospital during the study period based on the prevalence and associating risk

factors of infertility in female adults.

1.8 CONTEXTUAL DEFINITION OF TERM

Prevalence

infertility

infertility in general is defined as not being able to get pregnant (conceive) after one year (or

longer) of unprotected sex.

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 Knowledge on the risk factors and preventive measures of infertility in female adults aged
18-50years At The Laquintinie Hospital Douala

CHAPTER THREE

MATERIALS AND METHODS

3.1 STUDY SETTING

This study will be carry out at Laquintini hospital within the period of two months. The

hospital was created in 1931. Laquintinie is a referral Hospital situated at the center of

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 Knowledge on the risk factors and preventive measures of infertility in female adults aged
18-50years At The Laquintinie Hospital Douala

Akwa (Bonako quarter). It is bounded at the Nord by “ La Palais Dika Akwa”, at the South

by the Ngodi Cemetery, in the west by La Salle des Fetes d’Akwa and by east by Akwa

Polyclinic. The purpose of this study is to ASSESS THE KNOWLEDGE ON THE RISK

FACTORS AND PREVENTIVE MEASURES OF INFERTILITY IN FEMALE ADULTS

at the study site.

This design will be used because it is cheap and fast to managed.

3.2 STUDY AND STUDY DESIGN

A hospital based retrospective study which will be conducted at the Laquintini Hospital Douala

to evaluate The knowledge on the risk factors and prevention of infertility.

3.3 TARGET POPULATION, SAMPLE AND SUBJECTS

All female adults aged 18-50years at the Laquintini hospital Douala from the first of april to the

31 of May.

3.4 SAMPLE SIZE CALCULATION, POWER AND VARIABILITY

The following sample size determination formula for finite population (& Lemeshow 1991) will

be used to estimate the sample size.

n2 = NZ2P(1-P)

D2(N-1) + Z2P(1-P)

n2 = sample size with finite population correction

N = size of the target population (20 x 24)

Z = statistic for 95% level of confidence (z =1.96)

P = estimated prevalence of female adult infertility ~ 24.3%

D = magine of error = 2.1%

n2 = 480 x1.962x 0.0406(1-0.0406)

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 Knowledge on the risk factors and preventive measures of infertility in female adults aged
18-50years At The Laquintinie Hospital Douala

0.0212(480-1) +1.9620.0406(1-0.0406)

n2 = 200

200 patients (minimal sample size)

3.5 SAMPLING METHOD AND RECRITMENT OF PARTICIPANT

The use of questionaires

3.6 STUDY VARIABLES AND MEASUREMENTS

3.7 DATA COLLECTION

A questionnaire was used for data collection. The questionnaire was made up of closed ended

questions which gave the respondents opportunity to choose from the alternatives.

3.8 DATA MANAGEMENT

• The data collected will be entered into Microsoft excel 2010

• Data gathered from the field will be impacted in SPPS (statistics product and service

solution) version 20 and will be analyzed at a confident level of 95% error free.

Result obtained was presented on tables, bars chart, pie chart and histogram. 32 giga

bytes will be used to store the data and work plan.

• Data collected will be summarized in an abstract and power point

• The findin gs will be communicated

3.9 ETHICAL ISSUES

In order not to go against participant’s right and to maintain the confidentiality, the following

will be done before the research;

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 Knowledge on the risk factors and preventive measures of infertility in female adults aged
18-50years At The Laquintinie Hospital Douala

• A research proposal will be submitted to school and to the regional delegation for

authorization

• When Authorization from Regional delegation of public health is done it will now be

submitted to the hospital for authorization

• Permission will be gotten from the study site after submission

• Patients’ confidentiality was strictly observed by coding patiens’s names and

information into the questionnaire and these code will be subseqently used for

reference, analysis and presentation of the findings of the study. The data and

information will only be available to the investigator and the statistician. No patient

will still be on follow up during the study so there will be no contact with any of them.

Only the patient’s records will be used.

3.10 ACTIVITIES TIMELINE

Monday Tuesday Wednesday Thursday Friday

Week one Presentation Collection Same as Keying of Evaluation of
Of myself and analysis and Tuesday information the work and
obtained assisting in
the time filling of
vaccinations
table questionnaires

Week two Same as Same as Same as Same as Assisting in

Tuesday Tuesday Tuesday Tuesday other activities
in the hospital

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 Knowledge on the risk factors and preventive measures of infertility in female adults aged
18-50years At The Laquintinie Hospital Douala

Week Same as Same as Same as Evaluation Data

three Tuesday Tuesday Tuesday with staff compilation
and write up

Week Same as Same as Same as Evaluation Data

four Tuesday Tuesday Tuesday with staff compilation
and write up

Week Same as Same as Same as Evaluation Data

five Tuesday Tuesday Tuesday with staff compilation
and write up

Week six Same as Same as Same as Evaluation Data

Tuesday Tuesday Tuesday with staff compilation
and write up

Week Same as Same as Same as Evaluation Data

seven Tuesday Tuesday Tuesday with staff compilation
and write up

3.11 ITEMIZED BUDGET

Items Quantities Unit price Amount Justification

Pen 1packet 100frs 5000frs To disinfect

Face mask 20 100frs 2000frs protection

Disposable 1packets 5000frs 5000frs prevention

glove

Transportation 40days 500frs 20000frs

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 Knowledge on the risk factors and preventive measures of infertility in female adults aged
18-50years At The Laquintinie Hospital Douala

Printing of 10 6000frs 60000frs For

research authorization
proposal
Printing of 4copies 5000frs 20000frs For presentation
research project of result

Total 107,500frs

REFERENCES

1) Adebayo, P.K. (2019): Adolescent Reproductive Health Behaviour in Nigeria; Ibadan.

NISER. Bunting L, Tsibulsky I, Boivin J. (2013). Fertility knowledge and beliefs about fertility
treatment: findings from the international fertility decision-making study. Hum Reprod.
https://doi.org/10.1093/humrep/des4

2) Deatsman, S., Vasilopoulos, T. &Rhoton Vlasak A.(2016). Age and fertility: a study on
patient awareness. JBRA Assist Reprod. 2016. https://doi.org/10.5935/1518 0557.20160024

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 Knowledge on the risk factors and preventive measures of infertility in female adults aged
18-50years At The Laquintinie Hospital Douala

3) Emeh J.A. (2001): Childlessness: The easy way out; in Humanity health digests. Health
digests Network Lagos Nigeria. FMOH (2002): Technical Report of the 200 National
HIV/Syphilis Sentinel survey among women attending ante natal clinic in Nigeria. FOS/UNICEF
(2000): Multiple Cluster Indicator Survey. FOS Lagos. Galli N (1993): Foundation and
Principles of Health Education Hazards of Work. Equal Opportunities Commission. Manchester
200 4)UNIJERPS Unizik Journal of Educational Research and Policy Studies VOL.10 (1);
https://unijerps.org January-June, 2022 Hornstein, M. (2018) Is insurance coverage for in vitro
fertilization a good thing? FertilSteril. https://doi.org/10.1016/j.fertnstert.20 18.02.012.

5) Lewis T.L.T. (1985): Gynaecology by Ten Teachers Edited by Stanley G. Clayton. 14th
Edition, Oxford University Press. Britain. NPC (2000): Nigeria national Reproductive Health
Strategic frame work and plan 2002-2006. Abuja Federal Ministry of Health.

6) Shapiro, A. J., Darmon, S. K., Barad, D. H., Albertini, D. F., Gleicher, N. &Kushnir, V.A.
(2017). Effects of race and ethnicity on utilization and outcomes of assisted reproductive
technology in the USA. Reproductive Biology and Endocrinology.
https://doi.org/10.1186/s12958 017-0262-5

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