Impediments of Infertility Units in Low-Income Countries: Two Hospitals Examples in Senegal

Objectives: The aim of this study was to identify impediments of quality of infertility care units.
Patients and methods: This is a retrospective study leaded in two hospitals in Dakar (Senegal): Pikine National Hospital (PNH) and Aristide Le Dantec Teaching Hospital (LDTH) for 18 months from January the 1st 2015 to June 30th 2016. It included all couples presenting in our services for desire for pregnancy.
Results: The mean age of women was 32.7 years for women and 40.4 years for men. More than half of couples (51.3%) consulted after 5 years of attempt at conception. In both hospitals andrological history was not reported. Physicians prescribed semen analysis to 77.3% of couples at LDTH and in 31.5% at PNH. Antral follicular count (AFC) was not done in any of the 252 patients. At the LDTH, 75% of patients carried out the prescribed paraclinic exams.
Conclusion: In our study we have identified many impediments: unmet need in treating infertility, lack of physicians training, immigration and other social phenomenon (using alternative medicine, non-adherence of spouse in care). Access to infertility treatment is also limited by economics barriers. Physicians’ training is the cornerstones of quality of services.