The trajectories of infertility in the Gambia

Introduction: The prevalence of infertility globally among reproductive-aged couples is increasing. Although there are regional disparities in prevalence, the influence of environmental, cultural, and societal factors on sexual and reproductive health rights cannot be overemphasized. In view of the rising trend of infertility prevalence worldwide, we decided to do a desktop review of the literature 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 Queries included articles published or unpublished from 1998 to 2023.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 the trend of changes was 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%. Overall prevalence was 12.6%. In 2017, the primary rate was 4.8% and the secondary rate was 9.5% resulting in a prevalence of 14.3%. About 1:7 couples who attended gynecology clinics presented with infertility. Primary and Secondary infertility rates were 13.6% and 5.7%, respectively, in 2023. The prevalence of 19.3% about approximately 1:5 couples. That tubal factor has decreased from 17.4% in 2017 to 13.2% in 2023. The male factor increased by multiple 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. The male factor increased 3-fold 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 a high prevalence of male factor infertility, which may be responsible for the change in infertility epidemiology in the Gambia