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Association of Anti-Mullerian Hormone on the Quality of Human Oocytes in Some Patients Accessing in Vitro Fertilization (IVF) Treatment in a Private Fertility Center in Ghana  [PDF]
Dickson Mawusi, Muller Makafui Mawusi, Gideon Kwesi Nakotey
Advances in Reproductive Sciences (ARSci) , 2025, DOI: 10.4236/arsci.2025.134018
Abstract: The quantity and quality of oocytes obtained after egg harvesting or retrieval have been regarded as a variable that influences fertilization and the development of viable embryos, determining the number of good embryos required for embryo transfer to achieve implantation (biochemical and clinical pregnancies), as well as the freezing of remaining embryos for future use. This study determined the effects of AMH on oocyte quantity and quality in response to controlled ovarian stimulation (COS) in women undergoing IVF treatment in Ghana. We performed a cohort prospective study at an IVF center in Ghana. Data analysis was performed according to five AMH ranges: group 1 ≤ 0.3 ng/mL (probably negligible response); Group 2 > 0.3 ≤ 2.19 ng/mL (expected lower response); Group 3 > 2.19 ≤ 4.00 ng/mL (possibly intermediate response); Group 4 > 4.00 and ≤6.79 ng/mL (normal response); and Group 5: ≥ 6.79 ng/mL (high response). The number of metaphase II oocytes obtained in each group was recorded. 426 patients were admitted. The data presented were limited to the first IVF cycles to minimize repeated-measures bias. Eight cycles were cancelled due to poor ovarian response. The remaining 418 retrieval cycles were divided into five subgroups according to AMH categories: group 1 ≤ 0.30 (n = 20), group 2 > 0.30 ≤ 2.19 (n = 132), group 3 > 2.19 ≤ 4.00 (n = 158), group 4 > 4.00 ≤ 6.79 (n = 73), and group 5 ≥ 6.79 (n = 35). AMH is the best ovarian reserve test (ORT) for predicting and individualizing gonadotropin dosing to achieve appropriate ovarian responsiveness and minimize both hyper- and poor-ovarian response. This study also demonstrated that anti-Müllerian hormone is a fairly robust metric for predicting cancellation and the number of oocytes that may be retrieved after stimulation in some Ghanaian women undergoing IVF treatment; however, it is a relatively poor predictor of oocyte quality.
Impact of Anti-Mullerian Hormone on Fertilization and Embryo Development in Some Patients Accessing IVF Treatment in a Private Fertility Center in Ghana  [PDF]
Dickson Mawusi, Muller Makafui Mawusi, Gideon Kwesi Nakotey
Advances in Reproductive Sciences (ARSci) , 2025, DOI: 10.4236/arsci.2025.134020
Abstract: AMH has universally been accepted to correlate well with ovarian response to gonadotropin stimulation, but its effect on IVF outcomes remains undefined. Despite being a good marker of COS, AMH has not been able to predict fertilization rate, embryo development competence, and pregnancy outcomes in IVF programs. We conducted a prospective cohort study at an IVF center in Ghana. A total of 5238 oocytes were retrieved at ovum pick up (OPU) from 418 women, and a total of 4276 mature oocytes (metaphase II) were obtained. Following oocyte evaluation, 962 oocytes were found to be defective and therefore were discarded. Cycle and patient characteristics were expressed as mean ± standard deviation for continuous variables; percentages were used for categorical variables. Mean ± standard deviation was used to evaluate the relationship between serum AMH levels and continuous variables. Results were expressed in percentages. Bar charts, pie diagrams, and linear graphs were plotted to assess the influence of AMH levels on the number of metaphase II oocytes obtained, oocyte dysmorphism, fertilization rates, embryo development (on days 2, 3, and 5), and blastocyst formation (on day 5). This study presents preliminary ovarian biomarker baseline clinical data for ART practitioners on the application of AMH in IVF treatment for Ghanaian women. The clinical application depends on individual centers examining their data, correlating AMH levels and ultimate ovarian response in the form of metaphase II oocytes, fertilization rates, and embryo development. It is recommended that future research or further studies be conducted on a large sample size to define the role of AMH in IVF outcomes.
Patterns of Semen Analysis of Male Patients Undergoing in Vitro Fertilization Treatment in a Private Fertility Center in Ghana  [PDF]
Dickson Mawusi, Muller Makafui Mawusi, Gideon Kwesi Nakotey
Advances in Reproductive Sciences (ARSci) , 2025, DOI: 10.4236/arsci.2025.134019
Abstract: Male infertility is known to contribute to about half of all infertility cases. In Ghana, the prevalence of male infertility is higher (15.8%) than in females (11.8%). We evaluated descriptive parameters of semen analysis obtained from males in the workup of infertility in some men undergoing sub-fertility/in vitro fertilization (IVF) treatment. We conducted a prospective cohort study in a specialized IVF center in Ghana involving 558 men who reported with their female partners for sub-fertility treatment (clinically diagnosed). Patient selection criteria were based on sub-fertility partners participating in an IVF/ Intracytoplasmic Sperm Injection (ICSI) program. The clients were considered eligible for inclusion in the study if the male partner had motile ejaculated spermatozoa during preliminary semen analysis and before controlled ovarian stimulation (COS). The age group of the men was 27 to 65 years. Exclusion criteria were: previous disease(s) or surgery associated with reproductive function (including varicocele, cryptorchidism, epididymitis, mumps, azoospermia); vasectomy and vasectomy reversal. Clients were questioned regarding their careers, smoking habits, alcohol consumption, medical and family histories. All cases of severe alteration in spermatogenesis, including frozen and surgically retrieved sperm, prostatitis, and or patients who had prior cancer therapy were excluded from this study. Semen samples were then collected by masturbation into sterile containers and analyzed following WHO guidance for semen analysis within 60 minutes after ejaculation and collection. The total number of spermatozoa, and percentages of progressively motile (PR) and morphologically normal spermatozoa, equal to or above the lower reference limits (Normozoospermia) were observed in men less than 40 years (13.38%) and compared to men between 40 - 50 years (13.71%) and those above 50years. The highest percentage of progressively motile (PR) spermatozoa below the lower reference limit (Asthenozoospermia) was observed in men older than 50 years (35.00%) as compared to men less than 40 years (5.43%) and those between 40 and 50 years (4.68%). The highest total number of spermatozoa below the lower reference limit (Oligozoospermia) was observed in men older than 50 years (30.00%) as compared to men less than 40 years (27.20%) and those between 40 and 50 years of age (22.41%). Semen analysis from a small population of some Ghanaian men undergoing IVF treatment showed that morphologically normal spermatozoa below the lower reference limit
The Effect of Contraceptive Practice on Fertility in Ghana: A Decade of Experience
Boadu, Kwame
Canadian Studies in Population , 2002,
Abstract: English This study examines some factors that influence fertility behaviour in Ghana,with particular emphasis on the influence of contraception as an intermediate variable. The decadeexamined covers the period 1988 to 1998 and the factors analyzed are age, residence, education,religion and ethnicity. Employing multivariate regression analysis and path models, the study observesthat among all the factors, age is the only variable that has a moderate effect on fertility. Also ofsignificant interest is that the positive influence of contraceptive use on fertility in 1988 isreversed in 1998. The study notes that given the non-significant effects obtained save the moderateeffect of age, it is not possible to draw a definitive conclusion regarding the impact that any ofthese factors might have contributed to the observed reduction in fertility during the period. Inlight of this, the study recommends that more effort would be required if fertility is to be reducedsubstantially. Nonetheless, the reversal in the effect of contraceptive use between the two periods isseen as encouraging. French Cette étude porte sur certains facteurs qui ont une incidence sur le comportement procréateur au Ghana. Une attention particulière a été accordée à l'influence de la contraception en tant que variable intermédiaire. L'étude porte sur la période allant de 1988 à 1998 et sur les facteurs tels que l'age, le lieu de résidence, l'éducation, la religion et l'ethnicité. Basée sur l'analyse de régression multidimensionnelle et des modèles causaux, l'étude fait remarquer que de tous les facteurs, l'age est la seule variable présente une conséquence modérée sur la fertilité. Il est également intéressant de noter que l'influence positive de la contraception en 1988 a été renversée en 1998. Les auteurs de l'étude soulignent que compte tenu des résultats peu importants obtenus, hormis l'effet modéré de l'age, il est impossible de tirer une conclusion définitive en ce qui concerne l'impact de ces facteurs sur la réduction de la fertilité observée pendant cette période. Compte tenu de cela, les auteurs recommandent une hausse des mesures si l'on veut réduire la fertilité considérablement. Quoi qu'il en soit le revirement des conséquences des pratiques contraceptives pendant les deux périodes est considéré comme encourageant.
Examining the predictive value of fertility preferences among Ghanaian women
Ivy Kodzi,David Johnson,John Casterline
Demographic Research , 2010,
Abstract: Despite extensive research, doubts remain regarding the degree of correspondence between prior stated fertility preferences and subsequent fertility behavior. Preference instability is a factor that potentially undermines predictiveness. Furthermore, if other predictors of fertility substantially explain fertility, then knowledge of preferences may contribute little to explaining or predicting individual fertility behavior. In this study, we examined these aspects of the study of individual fertility preference-behavior consistency. Using a prospective multi-wave panel dataset, we modeled the monthly likelihood of conception, taking into account the dynamic nature of preferences, and controlling for changing reproductive life cycle factors and stable socioeconomic background predictors of fertility. We demonstrate from a sample of fecund married Ghanaian women that fertility preferences retain independent predictive power in the model predicting the likelihood of conception.
Demographic patterns and trends in Central Ghana: baseline indicators from the Kintampo Health and Demographic Surveillance System
Seth Owusu-Agyei,Obed Ernest A. Nettey,Charles Zandoh,Abubakari Sulemana
Global Health Action , 2012, DOI: 10.3402/gha.v5i0.19033
Abstract: Background: The dearth of health and demographic data in sub-Saharan Africa from vital registration systems and its impact on effective planning for health and socio-economic development is widely documented. Health and Demographic Surveillance Systems have the capacity to address the dearth of quality data for policy making in resource-poor settings. Objective: This article demonstrates the utility of the Kintampo Health and Demographic Surveillance System (KHDSS) by showing the patterns and trends of population change from 2005 to 2009 in the Kintampo North Municipality and Kintampo South districts of Ghana through data obtained from the KHDSS biannual update rounds. Design: Basic demographic rates for fertility, mortality, and migration were computed by year. School enrolment was computed as a percentage in school by age and sex for 6–18 year-olds. Socio-economic status was derived by use of Principal Components Analysis on household assets. Results: Over the period, an earlier fertility decline was reversed in 2009; mortality declined slightly for all age-groups, and a significant share of working-age population was lost through out-migration. Large minorities of children of school-going age are not in school. Socio-economic factors are shown to be important determinants of fertility and mortality. Conclusion : Strengthening the capacity of HDSSs could offer added value to evidence-driven policymaking at local level.
Intentional replacement of dead children in sub-Saharan Africa: evidence from Ghana and Kenya
Rajulton, Fernando,Gyimah, Stephen Obeng
Canadian Studies in Population , 2004,
Abstract: English This paper examines whether childhood deaths elicit an explicit, conscious andintentional fertility response using the 1998 Demographic and Health Surveydata for Ghana and Kenya . Using multivariate hazard models, childhoodmortality experience was found to have long term fertility implications beyondthe short term physiological effects. In both countries, women who haveexperienced childhood mortality were found to have significantly higher numberof additional children than those without. The death of the first child inparticular was found to be associated with the risk of a higher order birthconsistent with recent findings in Cameroon. The policy implications of thefindings are discussed. French Cet article examine si les décès d’enfants élicitent une réaction de féconditéexplicite, consciente et intentionnelle à partir des données pour le Ghana et leKenya contenues dans le Programme d’enquête démographiques et sanitaires de1998. Au moyen de modèles de dangers multidimensionnels, on a constaté quel’expérience d’un décès d’enfant avait des conséquences à long terme sur lafécondité allant bien au-delà des effets physiologiques à court terme. Dans lesdeux pays, les femmes, qui avaient perdu des enfants, avaient considérablementplus d’enfants que les femmes qui n’en avaient pas perdus. On a d’ailleurs établique le décès d’un premier enfant résultait en un plus grand ordre de naissances,ce qui a été confirmé par les dernières conclusions au Cameroun. Lesrépercussions en terme de politique sont traitées dans l’article.
Childbirth in East and West German Stepfamilies
Henz Ursula
Demographic Research , 2002,
Abstract: The present paper studies fertility rates in partnerships with and without children from previous partners in East and West Germany. Data from the German "Fertility and Family Survey" is used to estimate piecewise-linear hazard rate models for having another child. It turns out that a proportional-hazard model would give incorrect results because childbirth follows different time patterns for couples who have already a shared child and couples who do not. Therefore, a model with specific clocks for various experiences of parenthood is specified. Based on these model estimations the probability for having another child within a certain time is calculated. In West Germany the estimated likelihood of having another child within six years varies little by child composition. In contrast, East-German couples with no shared child have a higher likelihood than couples with a shared child to have a child within six years.
Estimating Parametric Fertility Models with Open Birth Interval Data
Schmertmann Carl,Caetano André Junqueira
Demographic Research , 1999,
Abstract: In the past thirty years, more than 100 censuses gathered fertility data through questions on women's date of last birth. The standard "births last year" (BLY) approach for such data truncates timing information, using binary indicators for births in the prior year only. The first author recently proposed consistent, maximum-likelihood estimation approaches using untruncated date of last birth (DLB). In this paper we extend DLB techniques to parametric models. We construct estimators for Coale-Trussell M and m parameters from open interval lengths. We apply the new procedure to Brazilian census data, producing maps and spatial statistics for BLY and DLB m estimates in 723 municipalities in Minas Gerais. DLB estimators are less sensitive to sampling error than BLY estimators. This increased precision leads to clearer spatial patterns of fertility control, and to improved regression. (NOTE from the editorial office: to best view the HTML of this article, you should be using Windows 95 or higher. Readers using other operating systems may not be able to view all of the embedded symbols, and we suggest they use the PDF version instead.)
Is the Previously Reported Increase in Second- and Higher-order Birth Rates in Norway and Sweden from the mid-1970s Real or a Result of Inadequate Estimation Methods?
Kravdal ？ystein
Demographic Research , 2002,
Abstract: According to models estimated separately for second-, third-, and fourth-birth rates in Norway, an increase took place from the mid-1970s to about 1990, given age and duration since last previous birth. A similar rise in the birth rates was seen in Sweden, except that the upturn at short durations was sharper. It is shown in this study, using Norwegian register data, that the increase partly reflects earlier changes in lower-order parity transitions. When models for each parity transition are estimated jointly, with a common unobserved factor included, there is no longer an upward trend in Norwegian second-birth rates, but a very weak decline, and the increase in the higher-order birth rates is strongly reduced compared to that found in the simpler approach.
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