Infertility — defined as failure to achieve pregnancy after 12 months of regular unprotected intercourse — affects approximately 1 in 6 couples in Nigeria. In absolute terms, with Nigeria's large population, this represents millions of couples experiencing one of the most emotionally devastating medical conditions a person can face. The social and cultural consequences in Nigeria are particularly severe — infertility attracts significant stigma, often directed primarily at women, and is a common cause of marital breakdown.
Tubal factor infertility — caused by blockage or damage of the fallopian tubes preventing sperm from reaching the egg or the fertilised embryo from reaching the uterus — is the leading female infertility cause in Nigeria. The primary driver is pelvic inflammatory disease (PID) from untreated chlamydia, gonorrhoea, and polymicrobial infection. Given Nigeria's high STI prevalence and the significant rate of asymptomatic STI (chlamydia causes no symptoms in up to 70% of infected women), tubal damage occurs silently and is often only discovered during an infertility investigation.
The prevention of tubal infertility is straightforward: STI screening and treatment. Every infertility investigation at Mascot Healthcare includes chlamydia and gonorrhoea testing as a standard component — because treating a current infection, even if asymptomatic, prevents further damage even when previous damage has already occurred.
Polycystic ovary syndrome causes anovulatory infertility — the eggs develop but are not reliably released. PCOS affects approximately 10% of women of reproductive age and is the most common cause of anovulatory infertility. Most cases are treatable with oral ovulation induction (letrozole or clomiphene). The diagnosis requires pelvic scan + hormonal panel (LH:FSH ratio, AMH, testosterone).
WHO data consistently shows that male factor infertility — low sperm count, poor motility, abnormal morphology, or absent sperm — contributes to infertility in 40–50% of couples. Yet in Nigeria, a woman may undergo multiple invasive procedures before her partner has a semen analysis. A semen analysis costs less than ₦10,000, takes 30 minutes, and is the most important first-line investigation for infertility. It is performed at the same time as female investigations at Mascot Healthcare.
Submucosal fibroids (growing inside the uterine cavity) impair implantation. Large intramural fibroids distort the cavity. Intrauterine adhesions (Asherman's syndrome) — typically from previous uterine surgery (D&C, manual vacuum aspiration) or severe infection — prevent implantation. All identified on pelvic ultrasound scan.
About the author: Dr. Chioma Ezenwachi is women's health physician, mascot healthcare at Mascot Healthcare, Akoka, Lagos. This article is reviewed annually and updated to reflect current guidelines and data.
Complete fertility workup for both partners at Mascot Healthcare, Akoka. Walk-in from ₦5,000.