Female infertility in Niger: clinical characteristics, etiologies and challenges in access to assisted reproductive care in a tertiary referral hospital
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Background Infertility affects nearly 48 million couples worldwide and remains a major public health concern in sub-Saharan Africa, where women frequently experience social stigma and marital instability related to childlessness. Access to assisted reproductive technologies remains extremely limited in low-resource settings. Objective To assess the prevalence, sociodemographic characteristics, etiologies, management patterns and challenges related to female infertility in a tertiary referral hospital in Niger. Methods We conducted a hospital-based retrospective cohort study at the Assisted Reproductive Technology Unit of the National Referral Hospital of Niamey, Niger, between January 2022 and December 2024. Women consulting for infertility and their partners were included. Sociodemographic, clinical, biological, radiological and therapeutic data were extracted from medical records and analyzed using SPSS version 25. Multivariable logistic regression was performed to identify factors associated with secondary infertility. Results Among 2153 women consulting during the study period, 398 were managed for infertility, corresponding to a hospital prevalence of 18.5%. Secondary infertility predominated (54.3%). The mean age was 32.1 ± 8.2 years, and women aged 30–39 years represented the largest group (46.2%). Tubal pathology was the leading female cause of infertility (34.7%), followed by hormonal disorders (29.9%) and uterine abnormalities (22.4%). Abnormal semen analysis was observed in 33.9% of male partners, including azoospermia in 4.0%. Ovulation induction was the most common treatment strategy. Only 4.0% of couples underwent intrauterine insemination, whereas 46.5% had an indication for IVF/ICSI, which was unavailable locally. The overall clinical pregnancy rate was 9.3%. Older age (AOR = 2.84; 95% CI: 1.91–4.22), salaried employment (AOR = 3.12; 95% CI: 2.01–4.83) and previous cesarean section (AOR = 1.58; 95% CI: 1.03–2.43) were independently associated with secondary infertility. Conclusion Female infertility in Niger is characterized by a predominance of secondary infertility and tubal disease, reflecting the burden of preventable reproductive tract disorders. Access to assisted reproductive technologies remains severely limited because of financial and structural barriers. Strengthening prevention strategies and improving access to affordable fertility care should be prioritized within national reproductive health policies.
Source: Research Square
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7204112469