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Popul Sci. 1991 Jan;10:41-58.

Infertility: a health problem in the Muslim world.



Between November 1980-August 1989, physicians in Cairo, Egypt followed 1488 infertile couples. The study reported the extent of infertility, its etiology, and problems related to its management. Primary and secondary infertility affected 70.7% and 29.3% of the couples, respectively. Length of infertility ranged from 1 to 23 years (mean = 7.18 for primary infertility and 6.05 for secondary infertility). 306 husbands (20.6% of the couples) had either an insufficient sperm count (20 X 1 million), insufficient sperm motility (40%), or 40% abnormal sperm. Both the husband and wife of 181 couples (12.2%) suffered from infertility. The physicians could not identify the cause of infertility in 49 couples (3.3%). 952 wives (64% of the couples) were infertile. Tubal problems were mainly responsible for female infertility (42%) followed by ovulatory disorders (25.3%), multiple factors (23.4%), pelvic endometriosis (5.6%), and cervical effects (4.2). Various treatments included laparoscopic adhesiolysis in 30 patients, tubal microsurgery in 523 patients, induction of ovulation and monitoring (e.g., clomid and HCG) in 224 patients, in vitro fertilization (IVF) and embryo transfer (ET) in 256 patients, artificial insemination with husband's capacitated sperm along with ovulation induction in 114 couples, intrauterine synechia and septa via hysteroscopy in 17 patients, and abdominal myomectomy in 57 patients. The follow-up pregnancy rate for 523 microsurgery patients was 55.2% and 38% went full term. Only 51-63% of the couples could afford to pay for IVF and ET, induction/monitoring of ovulation, or artificial insemination with husband's sperm all of which only the private sector provided. Patients had to wait for laparoscopy and microsurgery which were also available through government hospitals. These results demonstrate that prevention of infertility is preferable to treatment particularly in developing countries such as Egypt. Islam's view of infertility and family is also addressed.

[Indexed for MEDLINE]

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