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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 2  |  Issue : 1  |  Page : 26-28

Hormonal profile of some infertile women in bida Nigeria


1 Department of Medical Laboratory Science, Igbinedion University, Edo State, Nigeria
2 Department of Healthcare Services, Standard and Quality Control, Delta State Contributory Health Commission, Asaba, Nigeria
3 Department of Microbiology and Parasitology, College of Medicine, Delta State University, Abraka, Nigeria

Date of Web Publication27-Mar-2018

Correspondence Address:
Dr. Matthew Eturhobore Adu
Department of Healthcare Services, Standard and Quality control, Delta State Contributory Health Commission, Asaba
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/LJMS.LJMS_36_17

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  Abstract 


Background and Aim: The desire for reproduction is a basic human instinct, and it is well known that infertility is one of the psychosocial problems affecting many couples worldwide. The aim of this study is to evaluate the hormonal profile of infertile women in Bida metropolis. Materials and Methods: A total of 200 individuals comprising of 160 infertile and 40 fertile women as controls were recruited into this cross-sectional study in Bida metropolis, Nigeria. Serum luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), progesterone, and estradiol were determined using enzyme immunosorbent assay. Results: Infertile women had significantly higher LH and PRL level (P < 0.05) and statistically lower progesterone and estradiol level (P < 0.05) when compared to fertile women. There was no significant difference in FSH level of infertile women (P > 0.05) when compared to fertile women. Nonmenstruating women (NMW) had lower FSH and progesterone level (P < 0.05) and significantly higher PRL and estradiol level (P < 0.05) when compared to MW. There was no significant difference in LH level of NMW (P > 0.05) when compared to MW. Hormonal abnormalities were observed in 83.3% of the infertile women. This comprises of 30% secondary hypogonadism, 20% hyperprolactinemia/hypogonadism, 13.3% primary hypogonadism, 13.3% hyperestrogenemia, and 6.7% hyperprolactinemia. Conclusion: This study has shown that infertility remains a major problem affecting women of childbearing age. It is therefore recommended that couples should seek medical care on time as well as determine their hormonal status to correct any abnormality that might have arisen.

Keywords: Bida, hormone, infertile, Nigeria, women


How to cite this article:
Digban KA, Adu ME, Jemikalajah JD, Adama S. Hormonal profile of some infertile women in bida Nigeria. Libyan J Med Sci 2018;2:26-8

How to cite this URL:
Digban KA, Adu ME, Jemikalajah JD, Adama S. Hormonal profile of some infertile women in bida Nigeria. Libyan J Med Sci [serial online] 2018 [cited 2018 May 23];2:26-8. Available from: http://www.ljmsonline.com/text.asp?2018/2/1/26/228675




  Introduction Top


In Africa, children are the fabric of any society, without which no meaningful social and economic progress is considered worthwhile. Infertility is defined as the inability to conceive after one or 2 years of unprotected coitus among couples of reproductive age.[1] The reproductive age for women is between 15 and 49 years. Demographically, one can be considered infertile after 5 years exposure of unprotected consistent sexual intercourse and nonlactating.[2] Infertility is primary - if a pregnancy has never occurred, and secondary - if there has been a preceding pregnancy, irrespective of the outcome of the pregnancy. Okonofua [3] reported infertility as the most common reason for gynecological consultation in Africa which has placed huge burden on limited health-care resources. The causes of infertility vary from country to country and within different social groups.[4] Reproduction is controlled by a range of hormone such as follicle stimulating hormone (FSH), leuteinizing hormone (LH), prolactin (PRL), progesterone, and estradiol which must be at the optimal level before reproduction can take place. The alteration of these hormones results in infertility among women of childbearing age.[5] Therefore, this study sets to determine the female reproductive hormone profile and establish the possible cause of any alteration in these hormones.


  Materials and Methods Top


Study area

This study was carried out in Bida North-central Nigeria, a traditional city of Nupes with an estimated population of about 60,000 people with inhabitants majorly farmers, traders, and civil servants. The major ethnic groups are Nupe, Yoruba, and Igbo while intermarriage between these tribes occurs quite frequently.

Study population

A total of 200 female participants within the age of 15–45 years within Bida metropolis were recruited for this study from the fertility clinic of Federal Medical Centre, Bida. This consisted of 160 infertile women and 40 apparently healthy fertile women of reproductive age as (control). Participants were informed of the study and their consent obtained. Ethical clearance was obtained from the Institution Ethical Committee.

Inclusion and exclusion criteria

Female participants' age 15–45 years with an inability to conceive after 1 year of unprotected regular sexual intercourse were included in the study. Apparently, healthy female controls who were married and having children were included in the study as controls.

Exclusion criteria include female participants whose ages were below 15 years but not married and above 45 years. All infertile women who were currently on hormonal therapy for the treatment of their infertility were excluded. All pregnant and lactating women; women who were using hormonal injectable or oral contraceptives and women whose years of last childbirth were more than 5 years were excluded.

Collection of samples

A volume of 10 ml of blood specimen was aseptically collected from a peripheral vein (antecubital venipuncture) and dispensed into a plain container. This was allowed to clot and spun at 4000 rpm for 10 min to obtain a clear serum. The serum was separated into a plain container and kept frozen until analysis.

Biochemical analysis

Hormones (LH, FSH, PRL, progesterone, and estradiol) were determined using enzyme immunosorbent assay method according to manufacturer's instructions. All reagents were from DRG Diagnostics, Germany.


  Results Top


[Table 1] shows the mean and standard deviation of infertile and fertile women. The infertile women have a mean age of 31.7+/-3.2 while the fertile women have a mean age of 33.6+/-3.2. The mean age at menarche and mean duration of menstrual flow in the infertile women was not statistically different (P > 0.05) from those in fertile women, but the duration of menstrual cycles was significantly higher (P< 0.05) in infertile women than in fertile women. Infertile women had significantly lower (P< 0.05) estradiol and progesterone than control group but there was significantly higher (P< 0.05) PRL and LH in infertile women than fertile women when compared. There was no significant difference (P > 0.05) in FSH of both fertile and infertile participants.
Table 1: Mean and standard deviation and characteristics of infertile and fertile participants

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[Table 2] shows the comparison of hormonal profile of nonmenstruating women (NMW) and MW. Menstruating infertile women had significantly higher (P< 0.05) FSH, progesterone and estradiol than nonmenstruating infertile female. There was no significant difference (P > 0.05) in the LH level of the nonmenstruating and menstruating infertile women.
Table 2: Mean±standard deviation of hormonal profile in menstruating and nonmenstruating infertile women

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[Table 3] shows hormonal abnormalities in infertile women. Out of the 150 infertile females, 125 (83.3%) had abnormal hormonal levels. Hyperprolactinemia was found to be 6.7%, primary hypogonadism 13.3%, secondary hypogonadism 30%, hyperestrogenemia 13.3% while combined hyperprolactinemia/hypogonadism 20%.
Table 3: Mean age distribution of hormonal abnormalities among infertile women

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  Discussion Top


Our study revealed the mean age of infertile women as 31.7 years. This is in consonance with previous authors [6] who reported that majority of infertile women in an African setting are within the age of 30–36 years. It was also revealed that 3.3% of infertile women in this study were nonmenstruating while 96.7% of them were menstruating and the mean duration of infertility among the infertile women in this study was observed to be 6.8 years. This is in contrast with previous authors [6] who reported 2 years as the mean duration of infertility among infertile couples in developing countries. This difference may be attributed to the couple's effort in seeking fertility solution from the traditional birth attendant, specialist healers, and general medical practitioners so present late to clinics for infertility problems.

The study revealed significantly higher PRL and LH in infertile women than fertile women. This is findings confirmed the earlier report by previous authors [7] who reported similar results among infertile women. However, the hyperprolactinemia observed may be attributed to interference with ovulation process leading to infertility as earlier reported by Evers.[8] He further stated that the disruption of ovulation process may lead to decrease gonadotrophin-releasing hormone (GnRH), inhibition of LH and FSH release as well as inhibition of both estradiol and progesterone secretion in the ovary. It was observed that 6.7% of the infertile women had hyperprolactinemia as the cause of their infertility. This is consistent with findings of previous authors,[9] who reported 8.5% infertile women in Kano Northwestern Nigeria but in contrast with other reports [10] from Lagos, southwestern and Zaria Northwestern Nigeria that reported 48.9% and 50%, respectively.

In this study, infertile women had significantly lower progesterone and estradiol than fertile women, but there was no significant difference in their FSH level. This is in agreement with report from previous studies [7],[11] who reported similar pattern of results which may have accounted for primary hypogonadism in these infertile participants. Our study also revealed 13.3% of primary hypogonadism among the infertile participants. This is in contrast with earlier report of Emokpae et al.,[9] who observed 4.7% of primary hypogonadism among infertile women in their study. Primary hypogonadism is a diminished functional activity of the ovaries as a result of diminished sex hormone biosynthesis which may lead to failure to conceive. Primary hypogonadism may also be as a result of Turners syndrome, menopause and testicular feminization.

Our study further revealed 30% secondary hypogonadism (low FSH, LH, and Progesterone) in infertile women. This has been observed as the highest cause of female infertility in this study. This finding is in contrast with the earlier report of Emokpae et al.,[9] who reported 3.5% in Kano northwestern Nigeria. The genetic causes of secondary hypogonadism include kallmann syndrome (anosmia and GnRHs deficiency), cerebral tumor, head trauma, cerebral infection, cerebral radiation, and malnutrition. Other causes may include hyperprolactinemia, diabetes mellitus as well as marijuana. The study shows that 13.3% of the infertile women had hyperestrogenemia while 20.0% had both hyperprolactinemia and hypogonadism. This suggests that infertile women may have multiple endocrine disorders as causes of their infertility. The NMW had hyperprolactinemia as well as hyperestrogenemia which might be the cause of the cessation of their menstrual flow.


  Conclusion Top


Conclusively, it is pertinent to inferred that, infertility is a common disorder among women which may be attributed to hormonal imbalances that need to be corrected. We, therefore, recommend that hormone assay should be one of the diagnostic tools in the management of infertility among women of childbearing age.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Indria M, Sudhakar Babu C. Estrogen, progesterone and serum prolactin levels in infertility cases of women. IOSR J Dent Med Sci 2015;14:21-6.  Back to cited text no. 1
    
2.
American College of Obstetric and Gynecology (ACOG). Technical Bulletin-No. 197. Int J Gynecol Obstet 1994;47:306-12.  Back to cited text no. 2
    
3.
Okonofua F. Infertility and women's reproductive health in Africa. Afr J Reprod Health 1999;3:1-3.  Back to cited text no. 3
    
4.
Willocks J, Neilson JP. Obstetrics and Gynaecology. 4th ed. Edinburgh: Churchill Livingstone; 1991.  Back to cited text no. 4
    
5.
Prasad B, Parmar D, Sharma NC. A Study on Serum FSH, LH and prolactin levels among infertile women. Int J Med Res Health Sci 2015;4:876-8.  Back to cited text no. 5
    
6.
Cates W, Farley TM, Rowe PJ. Worldwide patterns of infertility: Is Africa different? Lancet 1985;2:596-8.  Back to cited text no. 6
[PUBMED]    
7.
Ben-Chioma AE, Tamuno-Emine DG. Evaluation of female fertility hormone profile in women with primary and secondary infertility. Int J Sci Res 2015;4:1583-5.  Back to cited text no. 7
    
8.
Evers JL. Female subfertility. Lancet 2002;360:151-9.  Back to cited text no. 8
[PUBMED]    
9.
Emokpae MA, Uadia PO, Mohammed AZ. Hormonal evaluations and endometrial biopsy in infertile women in Kano, Northern Nigeria: A comparative study. Ann Afr Med 2005;4:99-103.  Back to cited text no. 9
    
10.
Kuku SF, Akinyanju PA, Ojeifo JO. Serum levels of gonadotropins, prolactin, and progesterone in infertile female Africans. Int J Fertil 1987;32:393-8.  Back to cited text no. 10
    
11.
Daiter M. Progesterone: An overview and recent advances. J Sci 2007;65:55-8.  Back to cited text no. 11
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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