Parcours thérapeutiques et exposition cumulative aux traitements de l’infertilité chez les couples pris en charge aux Cliniques Universitaires de Kinshasa et à la Clinique Ngaliema : étude rétrospective multicentrique
Year: 2026
Type: article
Abstract: Infertility is a reproductive health problem whose management may involve several medical, hormonal, adjuvant, or surgical strategies. However, therapeutic pathways remain poorly described in available clinical data in the Democratic Republic of the Congo. This study aimed to describe therapeutic pathways and cumulative exposure to infertility treatments among couples followed at the University Clinics of Kinshasa (CUK) and Ngaliema Clinic between 2021 and 2025, and to identify factors associated with this exposure. A multicenter retrospective analytical observational study was conducted using medical records. Of 316 available records, 314 were included in the descriptive analyses, and 234 contained usable treatment information for the cumulative exposure analysis. Cumulative exposure was defined as the number of distinct therapeutic categories documented per couple. Data were summarized using counts, percentages, and measures of central tendency. Associations were estimated using univariable and multivariable Poisson regression with HC3 robust standard errors in Stata 16. Among the 234 couples, the most frequently documented categories were adjuvant treatments (41.0%), ovulation inducers (35.0%), other hormonal treatments (31.6%), and surgical treatments (24.8%). One therapeutic category was documented for 144 couples (61.5%), two for 66 (28.2%), and three for 24 (10.3%). Overall, 90 couples (38.5%) had at least two documented categories. After adjustment, female age 26–35 years (IRR = 1.4; 95% CI: 1.2–1.6; p < 0.001) and 36–45 years (IRR = 1.4; 95% CI: 1.2–1.5; p < 0.001), endometriosis (IRR = 1.2; 95% CI: 1.0–1.4; p = 0.024), and mixed etiology (IRR = 1.5; 95% CI: 1.2–1.9; p < 0.001) were associated with a higher expected number of categories. Male etiology was associated with a lower number (IRR = 0.8; 95% CI: 0.6–0.9; p = 0.012). Infertility duration was no longer significant after adjustment (p = 0.383). Documented cumulative exposure varied according to several clinical and etiological characteristics of couples. However, incomplete retrospective documentation did not allow precise reconstruction of treatment chronology or assessment of reproductive effectiveness. Standardized records and prospective multicenter cohorts are needed.
Source: REVUE DES SCIENCES DE LA SANTE
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7225595200