Early Clinical Outcomes and Associated Clinical Characteristics of Infertile Women on in-vitro Fertilization Treatment at a Tertiary Private Hospital in Kenya

Conclusions: Majority of the women who sought IVF treatment were married for at least five years, had a tertiary level of education, formally employed with health insurance and reproductive disorders. The overall pregnancy success rate 12 weeks after IVF treatment at Mediheal fertility centers is 37.1%. Previous fertility treatment was significantly associated with favourable early clinical outcomes of IVF, while having a normal BMI and regular menstrual cycle does not significantly increase the likelihood of normal pregnancy after IVF. Background: Infertility is a major cause of marital conflict and influences the quality of life of couples and their wellbeing. One of the definitive treatments for infertility is in-vitro fertilization (IVF). Despite this, not all patients who receive IVF treatment have favourable desirable clinical outcomes due to multiple underlying patients and procedural characteristics. Objectives: To determine early clinical characteristics and outcomes among women undergoing in-vitro fertilization treatment at a private tertiary hospital and fertility centers in Kenya. Methods : This was a one-year observational prospective study involving 153 women undergoing invitro fertilization as definitive treatment for infertility at Mediheal fertility centers in Eldoret and Nairobi. The participants were sampled consecutively over a nine-month accrual period and followed up at 2, 6 and 12 weeks of IVF treatment. Sociodemographic characteristics were collected using interviewer administered questionnaire. Pregnancy tests, first and second obstetric ultrasound were done on the 2 ^nd , 6 ^th and 12 ^th week after IVF treatment in order to determine early clinical outcomes. Pearson chi-square test and independent samples t-test were used to compare Clinical and Sociodemographic Characteristics and early clinical outcomes. Logistic regression model was used to assess the determinants of IVF success (critical value ≤0.05). Results: The mean age of participants was 36.2 (± 5.7) years. Majority 140 (91.5%) were married, 132 (86.3%) had a tertiary level education, 109 (71.2%) had health insurance and 95 (62.1%) had tried to have children for at least five years. Primary infertility was diagnosed among 83 (54.2%) women, 120 (78.4%) had regular menstrual cycle, regular coitus (>4 times a month) was in % 71 (46.4%) and 112 (73.2%) women had reproductive disorders. Pregnancy tests done on the second and eighth week among 145 women, had a positivity rate of 51.7% (n=75). On the week 6 visit, 61 of 70 women who had an obstetric ultrasound had a normal pregnancy. At 12 ^th week visit, all the 61 women returned for an obstetric ultrasound, with 52 being normal. The overall pregnancy success rates at weeks 2, 6 and 12 were 51.7%, 43.6% and 37.1% respectively. Women with a regular menstrual cycle (AOR=1.089; 95% CI: 0.741, 1.599) and primary infertility (AOR=1.051; 0.748, 1.477) were more likely to have positive pregnancy tests on the first follow-up visits. A normal BMI (AOR=2.216; 0.663, 7.405) and regular menstrual cycle (AOR=1.406; 0.398, 4.973) increased the likelihood of normal pregnancy at 12 weeks after IVF treatment. Previous intrauterine insemination (IUI) was significantly associated with normal pregnancy outcome after 12 weeks of IVF treatment.