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      Magnitude of infertility and associated factors among women attending selected public hospitals in Addis Ababa, Ethiopia: a cross-sectional study

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          Abstract

          Introduction

          The World Health Organization estimated that approximately 48 million couples and 186 million people are infertile worldwide. Although the problem of infertility is increasing worldwide, as well as in Ethiopia, there are limited studies done. Therefore, this study aims to determine the magnitude of infertility and the major risk factors in three governmental hospitals in Addis Ababa, Ethiopia.

          Method

          An institutional-based cross-sectional study design was used to conduct the study. The participants were selected by using a systematic random sampling technique. Data were collected through an interview using a structured questionnaire. The data were entered into Epi Data version 3.1 and exported to SPSS version 25 for analysis. Logistic regression was used to identify the predictor variables. Statistical significance was considered at a P < 0.05 with an adjusted odds ratio calculated at 95% CI.

          Result

          The overall prevalence of infertility was 27.6% (95%CI = 23.2, 32.0). Of these, 14.4% had primary infertility, and 13.2% had secondary infertility. Those whose duration of marriage was less than 60 months [AOR = 3.85; 95%CI 1.39, 10.64], had a history of fallopian tube obstructions [AOR = 8.27; 95%CI 2.36, 28.91], had irregular frequency of coitus [AOR = 37.4; 95%CI 11.29, 124.114], had more than one sex partner [AOR = 3.51; 95%CI 1.64, 7.54], had an abortion greater than 3 times [AOR = 6.89; 95%CI 1.28, 37.09], and had partners who currently consumed alcohol [AOR = 1.31; 95%CI 1.11, 1.86] were more likely to be infertile than their counterparts.

          Conclusion

          According to the results of this study, the prevalence of infertility was high compared to the global estimate of the World Health Organization. The government, health care providers, and researchers should emphasize developing appropriate strategies, research, education, and awareness creation of infertility and its potential causes.

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          Most cited references39

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          Fertility and infertility: Definition and epidemiology

          Infertility is a disease characterized by the failure to establish a clinical pregnancy after 12 months of regular and unprotected sexual intercourse. It is estimated to affect between 8 and 12% of reproductive-aged couples worldwide. Males are found to be solely responsible for 20-30% of infertility cases but contribute to 50% of cases overall. Secondary infertility is the most common form of female infertility around the globe, often due to reproductive tract infections. The three major factors influencing the spontaneous probability of conception are the time of unwanted non-conception, the age of the female partner and the disease-related infertility. The chance of becoming spontaneously pregnant declines with the duration before conception. The fertility decline in female already starts around 25-30 years of age and the median age at last birth is 40-41 years in most studied populations experiencing natural fertility. The disease-related infertility may affect both genders or be specific to one gender. The factors affecting both genders' fertility are hypogonadotrophic hypogonadism, hyperprolactinemia, disorders of ciliary function, cystic fibrosis, infections, systemic diseases and lifestyle related factors/diseases. Premature ovarian insufficiency, polycystic ovary syndrome, endometriosis, uterine fibroids and endometrial polyps may play a role in female infertility. Male infertility may be due to testicular and post-testicular deficiencies. Semen decline that has been observed over the years, endocrine disrupting chemicals and consanguinity are other factors that may be involved.
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            Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century.

            Infertility is estimated to affect as many as 186 million people worldwide. Although male infertility contributes to more than half of all cases of global childlessness, infertility remains a woman's social burden. Unfortunately, areas of the world with the highest rates of infertility are often those with poor access to assisted reproductive techniques (ARTs). In such settings, women may be abandoned to their childless destinies. However, emerging data suggest that making ART accessible and affordable is an important gender intervention. To that end, this article presents an overview of what we know about global infertility, ART and changing gender relations, posing five key questions: (i) why is infertility an ongoing global reproductive health problem? (ii) What are the gender effects of infertility, and are they changing over time? (iii) What do we know about the globalization of ART to resource-poor settings? (iv) How are new global initiatives attempting to improve access to IVF? (v) Finally, what can be done to overcome infertility, help the infertile and enhance low-cost IVF (LCIVF) activism?
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              International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care.

              INTRODUCTION The purpose of the present study was to review existing population surveys on the prevalence of infertility and proportion of couples seeking medical help for fertility problems. METHODS Population surveys, reporting the prevalence of infertility and proportion of couples seeking help in more and less developed countries, were reviewed. RESULTS Estimates on the prevalence of infertility came from 25 population surveys sampling 172 413 women. The 12-month prevalence rate ranged from 3.5% to 16.7% in more developed nations and from 6.9% to 9.3% in less-developed nations, with an estimated overall median prevalence of 9%. In 17 studies sampling 6410 women, the proportion of couples seeking medial care was, on average, 56.1% (range 42-76.3%) in more developed countries and 51.2% (range 27-74.1%) in less developed countries. The proportion of people actually receiving care was substantially less, 22.4%. Based on these estimates and on the current world population, 72.4 million women are currently infertile; of these, 40.5 million are currently seeking infertility medical care. CONCLUSIONS The current evidence indicates a 9% prevalence of infertility (of 12 months) with 56% of couples seeking medical care. These estimates are lower than those typically cited and are remarkably similar between more and less developed countries.
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                Author and article information

                Contributors
                mekdesakalewold17@gmail.com
                ziyadahm1982@gmail.com
                Journal
                BMC Womens Health
                BMC Womens Health
                BMC Women's Health
                BioMed Central (London )
                1472-6874
                11 January 2022
                11 January 2022
                2022
                : 22
                : 11
                Affiliations
                [1 ]GRID grid.414835.f, ISNI 0000 0004 0439 6364, Department of Public Relation and Communication, , Ethiopian Ministry of Health, ; Addis Ababa, Ethiopia
                [2 ]Department of Public Health, Yekatit 12 Hospital and Medical Colleges, Addis Ababa, Ethiopia
                [3 ]GRID grid.414835.f, ISNI 0000 0004 0439 6364, Department of Hygiene and Environmental Health, , Ethiopian Ministry of Health, ; Addis Ababa, Ethiopia
                [4 ]GRID grid.414835.f, ISNI 0000 0004 0439 6364, Department of Health Extension Program and Primary Health Care, , Ethiopian Ministry of Health, ; Addis Ababa, Ethiopia
                Author information
                https://orcid.org/0000-0003-3292-1085
                Article
                1601
                10.1186/s12905-022-01601-8
                8751301
                35012515
                755c4618-356c-498c-bb77-3215a85a1565
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 13 August 2021
                : 4 January 2022
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                Obstetrics & Gynecology
                infertility,magnitude,associated factors,addis ababa,ethiopia
                Obstetrics & Gynecology
                infertility, magnitude, associated factors, addis ababa, ethiopia

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