Attitude to sperm donation among medical students in Enugu, South-eastern Nigeria.

This study investigated the knowledge, attitude and practices of a sample of Nigerian medical students towards sperm donation. It was a self-administered semi-structured questionnaire survey of fifth and final year medical students of the College of Medicine, University of Nigeria, Enugu campus, South-eastern Nigeria. Out of 205 eligible medical students in both classes, 180 (87.8%) responded. There were 99 male and 81 female respondents. Their ages ranged from 20 to 30 years with a mean of 24.0 +/- 2.0 years. All the participants were Christians. A total of 177 (98.3%) of the respondents were aware of the practice of sperm donation for the treatment of infertility, while three students had never heard of it. A total of 15 (15.2%) of the male respondents reported their willingness to donate their sperm for infertile couples. The main motivation for wanting to donate sperm was a desire to help infertile couples. A total of 24 (30%) of the female respondents were willing to accept donor semen should the need arise. The leading factors which discouraged the male respondents from donating semen were that the practice was either against their religious belief (41.7%) or in their opinion, was morally wrong (22.6%). Some 10.7% were afraid of a possible adverse effect on future fertility, while 9.5% were afraid of being screened for sexually transmitted infections; 20 (35%) of the female respondents would not accept donor semen because of the psychological and emotional effects of having to bring up a child that is not their husband's; 13 (23%) said it was against their religious faith, while 10 (18%) believed that adopting a child was better than accepting donor semen. Eight (14%) were afraid of contracting HIV infection through donor semen, while six (11%) declined because they would not want the paternity of their child to be questioned later. With respect to the participants' views on identity disclosure, 35 (90%) of the 39 respondents willing to donate or accept sperm objected to their identities being disclosed to the recipient couples or the donor, while four (10%) did not mind. It was concluded that, despite the high level of awareness of sperm donation among medical students in Enugu, the majority of them were unfavourably disposed to it and none had ever practiced it. Public enlightenment through the mass media and correction of false notions about infertility treatment will go a long way in addressing this problem.

Pregnancy outcome in HIV-positive women in Enugu, Nigeria.

This is a retrospective case-control study of 62 HIV-positive women and 100 HIV-negative controls who delivered in the University of Nigeria Teaching Hospital, Enugu, from 2 August, 2002 to 31 March, 2004. The HIV-positive women were relatively younger and of lower mean parity than the HIV-negative controls. They were also significantly more likely to have positive syphilis serology, higher mean duration of labour, perineal tear, puerperal sepsis and higher mean duration of hospital stay, higher prevalence of low birth weight, birth asphyxia and more admissions to the Newborn Special Care Unit than the controls (p < 0.05). However, there was no significant difference in the two groups in the prevalence of hepatitis B surface antigenaemia, recurrent vulvovaginitis, abortions, stillbirths, congenital anomalies, pre-term delivery, mean interval between rupture of membranes and delivery and mode of delivery (p > 0.05). All (100%) the HIV-negative and 96.8% of the seropositive women had voluntary counselling and testing (VCT). There was no maternal death in either group. Untreated maternal HIV infection is associated with adverse pregnancy outcomes in the form of increased maternal and fetal morbidities. Hence for optimal outcomes, prevention of mother-to-child transmission (PMTCT) programmes must incorporate combination drug treatment for the mother as early in pregnancy as possible.