[Etiologic approach in infertile couples in Mahajanga].

In Madagascar, as in other places in the world, infertility is associated with social stigmatism and an underlaying long-term risk for separation of the couple. A 12 months prospective study was carried out in 1999 in the Department of Gynecology, Obstetrics and Reproductive Health at the University Hospital in Mahajanga in order to collect data related to possible causes of infertility. For the women, serologic tests for Treponema pallidum (syphilis) and Chlamydia trachomatis were performed. And, in addition to sonography and hysterosalpingography, cervico-vaginal smears were obtained as part of the pelvic examination. A semen sample was obtained from each male partner. Of the 37 couples enrolled in the study 35 were classified as primary infertile (n = 9) or secondary infertile (n = 28). The mean age of the women and the men was 30.7 years (ranged 20 to 41 years) and 34.3 years (ranged 24 to 46 years), respectively. Various potential causes of infertility among the women were observed, such as hormonal disturbance (76%), tubal occlusion (76%), genital infection (70%). The figures indicate that there seems to coexist the possibility of multiply causes of infertility. Of 37 semen samples 24 (65%) were found with abnormalities, predominantly of oligospermia type. In 21 couples a possibly cause of infertility was observed in both partners.