The prevalence of infertility in Africa is overshadowed by the high population growth
rate in this continent. The number of infertile black African women seeking treatment is
on the increase due to the fact that more black women are concentrating on their careers
and postponing having children.
The desire to reproduce is a highly motivating factor in most marriages and failure to do
so places a lot of stress on the couple. Infertile women in most parts of Africa are treated
as outcasts due to their infertile status. In most cases these women are either abused or
divorced by their husbands.
In sub-Saharan Africa, sexually transmitted diseases are the most common causes of
infertility. Other causes of infertility in women include endometriosis, anovulation, tubal
diseases, cervical factors and unexplained infertility.
Anorexia and bulimia nervosa, as well as obesity, produce alterations in the reproductive
system of women. Obesity has an effect on ovulation and on the outcomes of in vitro
fertilization and assisted reproduction therapy. Anorexia nervosa on the other hand, has
also been associated with amenorrhoea and oligoamenorrhoea.
Insulin resistance is another factor that is linked to polycystic ovarian syndrome and
infertility. Insulin resistance has also been shown to be prevalent in obese individuals,
especially those with android fat distribution. Lowering insulin resistance by weight loss,
results in spontaneous ovulation.
The main objective of this study was to determine the anthropometrical and biochemical
parameters in infertile black South African women. A total of sixty participants attending
the Unit for Reproductive Health, Universitas Hospital, Bloemfontein were included in
the study. Anthropometrical data measured included: body mass index; waist-to-hip
ratio; waist circumference; neck circumference and body fat percentage. Blood samples
were also obtained to determine the levels of fasting insulin, glucose, thyroid-stimulating
hormone, luteinizing hormone, follicle-stimulating hormone, leptin, prolactin,
progesterone, testosterone and C-reactive protein.
The results of this study show that tubal factor infertility was the most prevalent cause of
infertility and the second highest cause of infertility was male factors. The median age of
the subjects of this study was 32 years.
Sixty percent of the subjects had a gynoid fat distribution. More than a third of the
subjects had a body mass index of more than 25 kg/m² and none of the subjects in this
study had a body mass index of less than 18.5 kg/m². Eighty five percent of the subjects
had a body fat percentage of more than 32 percent. These results indicate that obesity is a
problem among these subjects.
Biochemical parameters indicate that the median concentrations of the reproductive
hormones were normal. Only 35 percent of the subjects had hyperinsulinaemia. Almost
all of the subjects (83.6%) had leptin concentrations above normal. Median C-reactive
protein level was also normal.
No association was found between body mass index and C-reactive protein and insulin.
An association was established between leptin concentrations and body mass index and
the correlation between these two parameters was very strong. An association was also
found between android fat distribution and hyperinsulinaemia.
The high rate of obesity among the subjects of this study, places the subjects of this study
at a risk of developing metabolic syndrome and other obesity-related factors. Their
obesity status may also be a contributory factor to their infertile status.
There should, be increased awareness of the impact of obesity on infertility and on their
general health. Increased physical activity and healthy food choices should be
encouraged among black infertile women. Black women should still be made aware of
the fact that there are facilities available for treatment of infertility.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:ufs/oai:etd.uovs.ac.za:etd-09302005-091018 |
| Date | 30 September 2005 |
| Creators | Motseki, Lucia |
| Contributors | Prof M Slabber, Dr Nortje |
| Publisher | University of the Free State |
| Source Sets | South African National ETD Portal |
| Language | en-uk |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.uovs.ac.za//theses/available/etd-09302005-091018/restricted/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University Free State or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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