Extent of infertility and associated factors in women attending selected public hospitals in Addis Ababa, Ethiopia: a cross-sectional study | BMC Women’s Health


Infertility is a disease of the male or female reproductive system that is defined as the inability to conceive after 12 months or more of regular, unprotected sex [1]. It is sometimes referred to as infertility, sterility, or physiological infertility, which is defined by demographers as the inability of a man, woman or couple to participate in reproduction. [2]. The terms subfertility and infertility are often used interchangeably, but they are not the same [3]. Subfertility is defined as a condition in which a couple is less fertile than a normal couple. Pregnancy can take longer when a couple is infertile. However, they can get pregnant on their own without medical help, as opposed to a condition called infertility. [3, 4]. The source of infertility can be female, male, both, or unexplained [5, 6]. Female infertility can be due to polycystic ovary syndrome, hormonal disorders, premature ovarian failure, genital infections, endometriosis, obstruction of the fallopian tubes, congenital uterine abnormalities, synechiae uterine, prolonged use of oral contraception, socio-cultural factors or other medical complications. [7, 8]. Men are only responsible for 20-30% of infertility cases, but contribute up to 50% of the total number of cases [9].

Infertility is a concern, suffering and stigma for couples facing this problem [10, 11]. It is more than a quality of life issue, with far-reaching consequences for public health, including psychological distress, social stigma, economic stress, marital disagreements, negative pregnancy outcomes and illnesses. of late onset in adults. [12]. In addition to the associated stigma and emotional distress, studies in South Asia and the Middle East have shown that infertility may be associated with increased interpersonal violence in infertile women. [13, 14].

Due to lifestyle changes and the presence of various environmental pressures, the prevalence of infertility has increased dramatically and has become the third most serious disease after cancer and cardiovascular disease. [15, 16]. WHO estimates estimate that between 48 million couples and 186 million people are living with infertility worldwide [1]. It is estimated to affect between 8 and 12% of couples of reproductive age worldwide [17]. However, in some parts of the world infertility rates are much higher, up to 30% in some populations. [18]. This is especially true in many regions with a high incidence of infertility, such as South Asia, sub-Saharan Africa, the Middle East and North Africa, Central and Eastern Europe, and Central Asia. . [5, 17, 18].

A study found that the proportion of couples seeking medical care is 56% in developed countries and 51% in developing countries [19]. Regardless of the widespread consequences of infertility, the provision of infertility medical care is limited in developing countries, including Africa, as more attention is paid to the problem of overpopulation and pending encouragement of childless couples to accept their condition. [8].

In many African countries, the success of marriage comes before a woman’s ability to have children, and being infertile leads to severe psychological trauma and social stigma. [8]. Especially for women, infertility drastically reduces their quality of life, exposing more sexual partners, sexually transmitted diseases, increased sexual dysfunctions and bad relationships. [20]. Although this is a common problem for both sexes, social blame and stigma are universally placed on women. [21, 22]. In Ethiopia, marriage, parenthood and children are highly valued and women are defined in the context of motherhood, which limits their role in the private sphere. [23]. A study carried out in Butajira showed that the prevalence of primary and secondary infertility was 2.9% and 16.1%, respectively [24]. Another study from Ethiopia showed that the prevalence of primary infertility decreased from 4.4% in 2000 to 3.3% in 2005, while secondary infertility fell from 4.3% in 2000 to 4 , 6% in 2005 [25]. A study in Addis Ababa regarding the infertile experience of women showed various negative emotional and psychological effects [26]. A study in Dessie identified age at first pregnancy, age at menarche, menstrual flow in days, history of STIs, and multiple sexual partners as the determining factors for infertility. [27].

Few studies have shown that the problem of infertility is increasing globally and in Ethiopia. To reduce the problem of infertility, individual and collective efforts must be supported by evidence. As such, continuing studies should be conducted to generate strong evidence that supports the resolution of the problem. As part of future evidence, this study aims to assess the prevalence of infertility and its associated factors among women of reproductive age visiting selected health facilities in Addis Ababa.


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