INFERTILITY IN THE GAMBIA: TRENDS AND PUBLIC HEALTH IMPLICATIONS

Introduction: The prevalence of infertility globally among reproductive-aged couples is increasing. Although there is regional disparities in prevalence which reflect differences in sexual and reproductive health and rights which is influenced by environmental, cultural, and societal factors. In view of the rising trend of infertility prevalence world-wide, we decided to do a desktop review of literatures regarding infertility in the Gambia. Methodology: A desktop review of available literature was performed. Queries included articles published or unpublished from 1998 to 2023. Keywords were prevalence, epidemiology and causes of infertility in the Gambia. Community and hospital based studies were identified and trend of changes measured with descriptive statistics. Results: The prevalence of infertility in the Gambia was 9% in 1998. Primary sterility was found to be fairly uncommon (3%), and secondary infertility to be more frequent (6%). In 2012, primary infertility was at 2% and secondary infertility at 10.6%. Over all prevalence was 12.6%. In 2017, primary was 4.8% and secondary was 9.5% a prevalence of 14.3%, about 1:7 couples that attended gynecology clinics presented with infertility. Primary and Secondary infertility was 13.6% and 5.7% in 2023. The prevalence of 19.3% about 1 in 5 couples. That Tubal factor has decreased from 17.4% in 2017 to 13.2% in 2023. Male factor increased by multiple of folds from 8.9% in 2017 to 45.4% in 2023. In 2017 and 2023 Ovulatory factor and Unexplained infertility were 13.4% and 22.4%; 10% and 13.8% respectively. Male factor increased 3-folds the tubal factor in 2023. Conclusion: The prevalence of infertility is increasing and primary infertility has become the most common type of infertility in the Gambia. The review showed high prevalence of male factor infertility which may be responsible for the change of infertility epidemiology in the Gambia