Female genital mutilation and other harmful practices
Health consequences of female genital mutilation
Infertility after female genital mutilation (FGM) in childhood
A hospital in Khartoum, Sudan, was the location for this case-control study of 99 infertile women under 35 years of age. All the women had had regular sexual intercourse during the previous two years, had never been pregnant, and had never used an intrauterine device or hormonal contraceptives. It was ascertained that none of the women’s infertility was due to hormonal factors or previous surgery, or to the infertility of their male partners. A control group consisted of 180 women expecting their first baby and receiving antenatal care.
Each of the 99 infertile women underwent diagnostic laparoscopy: 48 had adnexal pathology that indicated previous inflammation, one was inconclusive due to a large fibroid that made inspection impossible, and the rest showed no pathological features. Thirty of the 48 abnormal laparoscopies showed bilateral tubal blockage while the rest showed either unilateral blockages or adhesions.
Most of the infertile women and most of those in the control group had undergone some form of FGM. The researchers concluded that women with primary infertility were significantly more likely to have undergone the most extensive form of FGM (involving labia majora) than the controls. There were too few women without FGM (two cases and five controls) to allow for a comparison with them.
1. Almroth L, Elmusharaf S, El Hadi N, et al. Primary infertility after genital mutilation in girlhood in Sudan: a case-control study. Lancet 2005; 366(9483): 385-391.