Practical Difficulties in Estimating The Prevalence of Primary Infertility in Iran (original) (raw)
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Iranian journal of reproductive medicine, 2014
Infertility has a varied impact on multiple dimensions of health and functioning of women. We aimed to identify the burden of infertility and its influencing factors based on a population based study conducted in four provinces of Iran. A sample of 1126 women, aged 18-45 years, was selected using the multi stage, stratified probability sampling procedure; those met the eligibility criteria were invited for further comprehensive interview. This study used the definition of infertility proposed by World Health Organization "the woman has never conceived despite cohabitation and exposure to pregnancy for a period of 1 year". Results : The overall prevalence of lifetime infertility and current primary infertility were 21.1% (95% CI: 18.4- 23.8) and 6.4% (95% CI: 4.8-8) respectively. The probability of first pregnancy at the end of 2 years of marriage was 94% for all ever-married women. Infertility were observed as significantly higher among women age 31-35 (OR: 4.6; 95% CI: 1....
Prevalence of Primary Infertility in Iran in 2010
Iranian journal of public health, 2013
Infertility is one of the most significant medical, as well as social problems that affect psychological health of families and societies. Determining the prevalence of infertility is important for evaluating the potential of fertility. There are different reports on the prevalence of infertility in Iran, but the current research employs fertility history in order to provide an unbiased estimation of primary infertility. Data from a national survey of Iranian women aged 20-40 years was used in this study in year 2011. Totally, 1011 clusters were randomly selected according to post office codes, proportional to the population of the province. We evaluated the history of fertility as the basis for gathering information. Accordingly, we designed a questionnaire. Subsequently, we recruited and trained nurses and obstetricians to call on married women to fill the questionnaires. Primary infertility refers to a condition in which couples have not been able to conceive a child after one ye...
The trend of infertility in Iran, an original review and meta-analysis
Background & Aim: Worldwide prevalence of infertility has been reported to be 3-7% of all couples. There are varieties among the results of studies conducted on the prevalence of infertility in Iran. The present study aimed to evaluate the trend of infertility using meta-analysis method in Iran. Methods & Materials: We systematically reviewed all published papers in Medline database of the National Library of Medicine and their Persian equivalents (2001-2011). Findings which met the inclusion criteria were included. Random effects meta-analysis was applied to the data of 13 selected populations. Data manipulation and statistical analyses were performed using STATA. Results: Overall, 13 studies met our inclusion criteria. The pooled prevalence of infertility was 13.2% (95% CI: 8-18.3). The pooled prevalence of primary and secondary infertility were reported to be 5.2% (95% CI: 3.7-6.6) and 3.2% (95%CI: 2-4.4), respectively. The lowest and highest frequency of lifetime prevalence of infertility was 2.8% in 2001 and 24.9% in 2010, respectively. Meta-regression scatter plot showed an increasing trend in the prevalence of infertility during 2001-2011 (P = 0.58). Meta-regression did not indicate a significant correlation between the sample sizes and the prevalence of infertility (P = 0.64). Conclusion: The pooled infertility prevalence in Iran is higher than its mean worldwide, and lifetime infertility is increasing in recent years compared to the past in Iran.
International Journal of Impotence Research, 2008
To explore the prevalence and risk factors of infertility in Iran, a total of 12 285 ever-married women aged 15-50 years old and their husbands (if available) were interviewed by 82 female general practitioners and answered a self-administered questionnaire on several aspects of infertility. They were identified from the national population in 30 counties, and invited to a confidential interview. Data were obtained about their age, education, marital status, toxic habits, medical history, disabilities and illnesses, help-seeking, economy, ethnicity, geographic location, contraceptive use and age at which they had first intercourse. This study used the definition of childlessness proposed by World Health Organization: 'the woman has never conceived despite cohabitation and exposure to pregnancy for a period of 2 years'. The overall prevalence of infertility was 8% (95% CI: 3.2-15.0). The weighted national estimate of primary infertility was 4.6% (95% CI: 3.6-5.2). There was a pronounced regional pattern in the levels of primary infertility. The primary infertility increased significantly from 2.6 to 4.3 to 5.5% for the 1985-1989, 1990-1994 and 1995-2000 marriage cohorts. The prevalence of secondary infertility was 3.4% (95% CI: 2.4-5.1). Overall the prevalence of infertility falls within a relatively wide range being high in the Southern counties, and low in the Northern counties. The probability of first pregnancy at the end of 2 years of marriage was 0.78 for all ever-married women. The prevalence of infertility increased with age (linear chi-square 198.012, 1 d.f., p = 0.01). The age pattern of infertility also varies quite markedly across the counties analysed. No effect of race was detected; neither the intercept (analysis of covariance p = 0.36) nor the slope of the age relationship was influenced by race (analysis of covariance p = 0.41). Infertility were observed as significantly higher in the presence of history of tubo-ovarian surgery [odds ratio (OR): 1.43; 95% CI: 1.28-2.23; p = 0.01], salpingitis (OR: 2.34; 95% CI: 1.31-4.3; p = 0.016), ectopic pregnancy (OR: 2.45; 95% CI: 1.90-3.44; p = 0.04), varicocele (OR: 2.85; 95% CI: 1.61-5.20; p = 0.01) and cryptorchidism (OR: 3.81; 95% CI: 2.51-4.28; p = 0.031). This study provides a quantitative estimate of the prevalence and main risk factors for infertility in Iranian couples. Yet, further studies on the cause of primary and secondary infertility and geographical variations in the incidence and prevalence of infertility in Iran are needed.
An Overview of the Epidemiology of Primary Infertility in Iran
Journal of Reproduction Infertility, 2009
Introduction: This article compares the prevalence of primary infertility in Iran estimates provided by different studies. No other study had provided a review about the researches related to epidemiology of infertility in the country. Materials and Methods: A literature review was undertaken using the scientific resources on the internet and the list of national projects obtained from Deputy of Research and Technology, of Iran Ministry of Health and Medical Education (MOH & ME) and relevant research centers. These resources were attentively reviewed to find about national studies on the epidemiology of primary infertility in Iran during the last decade. Based on their design quality, the National Infertility Study (NIS) (2004-2005), National Health Survey (NHS) (2001) and Tehran Study were considered for the research. Results: Current primary infertility estimated by National Health Survey (NHS) was 2.8% and by National Infertility Survey (NIS) 3.4%. Tehran study and NIS estimated the prevalence of lifetime primary infertility to be 21.9% and 24.9%, respectively. The minimum prevalence of lifetime primary infertility was found to be 15.8% for the marriage age of 19-27 by Tehran study and 17.2% for the marriage age of 21-26 by NIS. Conclusion: On the average, 21-22% of women experience primary infertility during their marital life. The best age of marriage for women in Iran seems to be 20-27 years. At this age group, the lowest number of women (16-18%) would experience primary infertility.
Prevalence and Pattern of Infertility in Iran: A Systematic Review and Meta-Analysis Study
2021
Context: Infertility is a complex reproductive issue worldwide. Knowledge about the prevalence of any health problems like infertility is the first step towards policymaking in order to make effective decisions. Methods: An electronic systematic review was conducted in 2019 through search in PubMed, Scopus, Web of Science, Science Direct, and EMBASE data bases. Following the evaluation of the articles by the research team, 11 articles were accepted based on the inclusion criteria of the study. The information was analyzed utilizing Stata software version 11. Results: The results of analysis on 58,746 participants showed that the prevalence of primary infertility was 5.0% (95% CI: 4.0, 6.0%; I2: 98.20%) and the prevalence of secondary infertility was 2.0% (95% CI: 1.0, 3.0%; I2: 98.48%). The prevalence of primary and secondary infertility by gender was higher in women (6% and 3%, respectively). The prevalence of primary infertility was more common in people under the age of 35. Concl...
A Meta-Analysis of The Prevalence and Etiology of Infertility in Iran
Vol 17, No 3, July-September , 2023
Infertility is a serious health issue in the world affecting approximately 8-10% of couples worldwide. The meta-analysis study was performed to assess the prevalence and etiologic factors associated with infertility in Iran. We made sure that the implementation of study and reporting the results were consistent with the MOOSE and PRISMA guidelines, respectively. All stages of the research were conducted by two authors, and the disagreement at each stage of the research was resolved by consensus. On January 1, 2020, we started a detailed literature search on international online databases, and Iranian Online databases, as well as specialized journals, several authentic international publishers and Google Scholar. We reviewed the reference list of identified articles for missed articles and then searched online for them. Data analysis was performed to estimate the prevalence using a random effects model. The lifetime infertility prevalence was found to be 11.3% [95% confidence interval (CI): 8.6-14.7] and the current infertility was evaluated to be 3.7% (95% CI: 3.2-4.3). The prevalence of primary infertility (based on 45 articles consisting of 51,021 samples) as well as secondary infertility (based on 13 articles consisting of 35,683 samples) in Iran were estimated to be 18.3% (95% CI: 15.4-21.6) and 2.5% (95% CI: 1.6-4.0), respectively. The prevalence of female, male, both and unexplained causes was estimated to be 32.
Epidemiology and Etiology of Infertility in Iran, Systematic Review and Meta-Analysis
Background: Epidemiological study of infertility might let the related policy makers to make accurate decisions regarding the potential users' requirements for infertility workup or management. The objective of this study was to find the incidence and etiologic factors for infertility in Iranian population. Methods: an internet based search through PubMed, Google Scholar, Iran Medex, magiran and SID with the search terms including: "Iran" and "infertility" and "epidemiology" or "etiology" or "cause" and university library archives was performed that was restricted to the publications in the recent 25 years (since 1987-2012) in English or Persian. This project included all of the studies that were designed by random cluster sampling with face to face interviews at home from the Iranian population. Life time infertility was defined as inability to conceive after 12 months of unprotected intercourse. For analyzing the causes of infertility we included the published articles that were designed by Iranian infertility clinics and evaluated the causes of infertility by appropriate diagnostic techniques. Independent data extraction was performed by two observers and meta-analysis was done. Random affects metaanalyses, forest plot and Sata graph, publication bias and sensitivity analyses were performed. Results: Twelve studies that were designed to evaluate the prevalence rate of infertility were identified and meta-analysis was performed to integrate the findings of the separate studies. The average rate of infertility was; 10.9% (95% CI 7.4-14.4), Primary infertility; 10.6% (95% CI 5.3-16.0), secondary infertility; 2.7% (95% CI 1.9-3.5) and current infertility; 3.3% (95% CI 2.7-3.8). Causes of infertility were picked up from seven qualified studies. Male factor was; 34.0% (95%CI 26.9-42.0), female factor; 43.5% (95% CI 35.5-51.7), both male and female factors; 17.1% (95% CI 11.4-21.9) and unexplained cause; 8.1% (95% CI 5.6-11.5), respectively. Conclusions: Prevalence rate of life time infertility was 10.9%. The most common cause was female factor.
The Prevalence and Causes of Primary Infertility in Iran: A Population-Based Study
Global Journal of Health Science, 2015
Background: Primary infertility is a health issue among women over the world. The aim of this study was to investigate the prevalence and causes of primary infertility based on a population-based study in an urban area of Iran. Materials and Methods: In a cross-sectional study, a total of 1067 married women who participated in the Tehran Lipid and Glucose Study were randomly selected using systematic random sampling. Unmarried women, those with unwilling pregnancy and duration of marriage below one year were excluded from the study. Data was collected by using validated ad-hoc questionnaires. Descriptive and inferential statistics were used for data analysis. Results: The mean (SD) of age and marriage age of the studied women were 40.3 (9.3) and 20.6 (4.49) years, respectively; the overall prevalence of lifetime primary infertility among couples was 17.3% (185/1067). Ovulatory disorder (39.7%) and male factors (29.1%) were the main causes of primary infertility. In addition, 31 (17%) of the women were diagnosed with more than one cause. According to the logistic regression analysis, primary infertility was independently related to the old age of women (
Prevalence and Risk Factors of Infertility in a Southern Port City of Iran
Hormozgan Medical Journal, 2020
Background: Infertility is a universal problem with very limited scientific information relating to the factors that place men and women at risk of infertility. Objectives: To determine the prevalence and risk factors of infertility in Bandar Abbas, a Southern port city of Iran. Methods: We conducted this cross-sectional study using a face-to-face questionnaire survey from September 2017 to March 2018 among 1,500 women at childbearing age. Results: Data from 1469 valid questionnaires were finally assessed. There were 224 cases of current infertility with an incidence of 15.24% (95% CI, 14.79%-15.44%), including 151 primary (10.27%; 95% CI, 10.09%-11.14%) and 73 secondary (4.96%; 95% CI, 4.76%-5.09%) infertilities. According to the univariate logistic regression analysis, age of men and women, women's occupation, men engaged in high-temperature professions, age at marriage, menstrual cycle pattern, previous contraceptive usage, history of infertility in family, previous abortions, previous cesarean sections, number of pregnancies, previous vaginal delivery, smoking, physical activity, and BMI were significantly associated with infertility (all P ≤ 0.05). To determine the independent risk factors for infertility, multivariate logistic regression analysis was performed. Advanced age, heavy physical activity, obesity, men engaged in high-temperature professions, previous abortions, and previous cesarean sections were the risk factors for infertility. The number of pregnancies and previous vaginal deliveries were protective factors. Conclusions: Although infertility risk factors are complex and multiple, and the investigated region does not represent all areas of Iran, the results can contribute to the overall reproductive health improvement among Iranians.