Aims: Infertility is a major problem in our current societies and the Fertilia medical clinic in Bamako is a center for medical assistance in procreation (MAP) where there is an increasingly growing demand for ultrasound. The objective of our study was to investigate the ultrasound causes likely to prevent the occurrence of pregnancy in a group of infertile and subfertile women. Subjects and Methods: This was a 5-year cross-sectional and prospective study, between January 2017 and January 2022, which involved 250 women wishing to become pregnant (infertile or subfertile), who came for pelvic ultrasound or follicular monitoring and who agreed to participate in our study. The parameters used were ultrasound reports including uterine, ovarian and tubal pathologies. It should be noted that in some cases no ultrasound cause of infertility was found. Data were entered and analyzed in SPSS. Results: 250 women were recruited into our. The average age was 32 years with extremes ranging from 17 to 51 years. 179 patients or 71.6% were between 17 and 35 years old. 139 patients or 55.6% had secondary infertility against 44.4% primary infertility. 202 patients or 80.8% had at least one ultrasound lesion and 48 patients or 19.2% had no significant ultrasound abnormality. The most represented ultrasound lesions were of uterine origin with 72.20%, 23.7% ovarian lesions and 04% tubal lesions. Uterine lesions were dominated by myomas, adenomyosis, endometrial polyps, uterine malformations and synechiae. As for ovarian lesions we noted cysts, polycystic ovary syndrome (PCOS), ovarian endometriosis, non-follicular ovaries and tubal ultrasound lesions showed unilateral or bilateral hydrosalpinx. Conclusion: In our study, ultrasound was an invaluable contribution to the diagnosis of the causes likely to explain subfertility and infertility in our respondents. She highlighted uterine, ovarian and tubal lesions, some of which could be corrected and pregnancies ensued.
References
[1]
World Health Organization (WHO) (2020) Infertility. WHO, Geneva. https://www.who.int/fr/news-room/fact-sheets/detail/infertility
[2]
Le Goff, S., Lédée, N. and Bader, G. (2008) Obesity and Reproduction: Review of the Literature. Gynécologie Obstétrique & Fertilité, 36, 543-550. https://doi.org/10.1016/j.gyobfe.2008.03.005
[3]
Meng, Q., Ren, A., Zhang, L., et al. (2015) Incidence of Infertility and Risk Factors for Impaired Fertility in Newly Married Couples in a Chinese Population. Reproductive BioMedicine Online, 30, 92-100. https://doi.org/10.1016/j.rbmo.2014.10.002
[4]
Sakande, J., Sandjon, L.O., Ouedraogo, C., Konyaole, E., Kabre, E. and Sawadogo, M. (2012) Female Hormonal Profile and Prognosis of the Response to Ovarian Stimulation during Medically Assisted Procreation: Experience from Burkina Faso. International Journal of Biological and Chemical Sciences, 6, 950-958. https://doi.org/10.4314/ijbcs.v6i3.4
[5]
Ikechebelu, J.I., Eke, N.O., Eleje, G.U. and Umeobika, J.C. (2010) Comparism of the Diagnostic Accuracy of Laparoscopy with Dye Test and Hysterosalpingography in the Evaluation of Infertile Women in Nnewi, Nigeria. Tropical Journal of Laparo Endoscopy, 1, 39-44.
[6]
Kouamé, N., N’goan-Domoua, A.M., Konan, N., Sétchéou, A., Tra-Bi, O., N’gbesso, R.D. and Kéita, A.K. (2012) Contribution of Transvaginal Ultrasound Combined with Hysterosalpingography in the Etiological Research of Female Infertility in Abidjan (Ivory Coast). African Journal of Reproductive Health, 16, 43-49.
[7]
Kambou, T. (2016) Ultrasound Etiologies of Female Infertility in Ouagadougou.
[8]
Nana, D. (2021) Pelvic Ultrasound and Hysterosalpingography in Etiological Research on Female Infertility at Somine Dolo Hospital in Mopti. Thesis Med., FMOS, Bamako, 94 p.
[9]
Blanc, B., Zarka, V., Boubli, L. and Bautrant, E. (1992) Diagnostic Contribution of Explorations of the Female Genital Tract in a Sterility Assessment. Concept Fertilsex, 20, 198-204.
[10]
Thurmond, A.S. (2003) Imaging of Female Infertility. Radiologic Clinics of North America, 41, 757-767. https://doi.org/10.1016/S0033-8389(03)00064-2
[11]
Launay, S., Moisan, S., Partouche, A., Mestdagh, P., Rocourt, N. and Robert, Y. (2001) Female Infertility: Role of Ultrasound. Ultrasound in Medicine and Biology, 41, 459-472.
[12]
Shalev, J., Meizner, I., Bar-Hava, I., Dicker, D., Mashiach, R. and Ben-Rafael, Z. (2000) Predictive Value of Transvaginal Sonography Performed before Routine Diagnostic Hysteroscopy for Evaluation of Infertility. Fertility and Sterility, 73, 412-417. https://doi.org/10.1016/S0015-0282(99)00533-6
[13]
Gandji, S., Bankolé, H.S., Dougnon, T.V., Da Silva, J., Zannou, C. and Biaou, O. (2013) Occurrence of Tubal Obstructions in Women in Cotonou (Benin, Role of Bacteria). International Journal of Biological and Chemical Sciences, 7, 1338-1343. https://doi.org/10.4314/ijbcs.v7i3.39
[14]
Biaou, O., Adisso, S., Hounsossou, H., Takpara, I., Gandji, S. and Padonou, J. (2008) Contribution of Ovarian Ultrasound in the Exploration of Female Infertility in Benin. Review CAMES-Series A, 6, 15-20.
[15]
Barillier, H. (2007) Current Management of Female Sterility in France. Thesis Doctor of Pharmacy, No. 4023, FMOS, Bamako.
[16]
Gianni, F. and Csilla, K. (1998) Evaluation and Treatment of the Infertile Couple. The Journal of Clinical Endocrinology & Metabolism, 83, 4177-4188. https://doi.org/10.1210/jc.83.12.4177
[17]
Rezigua, H., Zouaghi, C., Bouguisen, S., Oueslati, H. and Marrakchi, H. (1994) Conjugal Sterility Analytical Study about 430 Cases. Medical Tunisia, 72, 681-685.
[18]
Ohl, J., Bettahar-Lebugle, K., Rongières, C. and Nisand, I. (2000) Role of Ultrasound in the Diagnosis of Female Infertility. Gynécologie Obstétrique & Fertilité, 28, 234-239.
[19]
Camus, E., Poncelet, C., Goffinet, F., Wainer, B., Merlet, F., Nisand, I. and Philippe, H.J. (1999) Pregnancy Rates after In-Vitro Fertilization in Cases of Tubal Infertility with and without Hydrosalpinx: A Meta-Analysis of Published Comparative Studies. Human Reproduction, 14, 1243-1249. https://doi.org/10.1093/humrep/14.5.1243
