Epidemiology of infertility in the Fez -Morocco-(About 258 couples)

Introduction: This work aimed to illustrate the epidemiology of infertility in the Fes region, taking into account the socio-psychological impact of this entity, which remains very poorly experienced, especially in Moroccan society.
Patients and methods: This is a retrospective, observational and analytical study, involving 258 couples, within the Gyneco-Obstetrics II department of the Hassan II University Hospital in Fes. Data collection was carried out in September 2018. as of March 2021 based on a questionnaire written for this purpose.
Results:
•         The average age of women was 32 years with extremes ranging from 22 to 42 years.
•         the time taken for consultations for the first time varying between 18 months and 4 years with an average of 02 years and 09 months
•         82% of couples had primary infertility and 7.59% had secondary infertility.
•         The duration of infertility varies between 1 year and 17 years with an average of 9 years, of which 26.6% of couples have infertility for more than 10 years.
•         Origin of infertility in our study is male in 44%, female in 36.6%, mixed in 6.6% and unexplained in 12.4% of couples.
•         The female etiology of infertility is: 25.5% of tubal origin, 31.5% of low ovarian reserve, 1.5% of premature ovarian failure, 29.3% of polycystic ovary syndrome, 4.5% of endometriotic origin and 7.5% of uterine origin.
•         In men the most common anomaly is asthenospermia in 36.1% of spouses.
•         therapeutic care :20 patients benefited from laparoscopy,either 7.8%, surgical HSC performed in 3.1%(8 patients),7 patients benefited from ovarian stimulation followed or not by intrauterine insemination, 2 of whom had a biochemical pregnancy. .
•         in Vitro Fertilization was indicated in 54 couples, or 20%, due to lack of resources, only 3 couples, or 5.6%, benefited from an in Vitro Fertilization attempt, one of which carried a pregnancy to term, giving a living child.
Conclusion: This study showed that infertility is the result of several causes and that a considerable percentage of etiologies require assisted procreation techniques which are very expensive, which blocks the support of couples, 94.4% of whom are still awaiting the creation of a local center and medical coverage allowing patient care