Sociodemographics and Risk Factors of Secondary Infertility in Pakistan: A Case-Control Study
Abstract
Infertile couples fail to achieve a clinical pregnancy after engaging in regular unprotected sexual intercourse for 12 months. Primary infertility refers to their inability to conceive without any previous successful pregnancies. Secondary infertility is the inability to conceive for a period of one year after conceived at least once. This study aimed to explore the risk factors and sociodemographics of secondary infertility. This case-control study was conducted at the University Institute of Public Health using data from the Gilani Ultrasound Center. The data were collected 18 months after the approval of the synopsis, examining a total of 690 females (345 cases and 345 controls). All females in the case group participated if they were 20–45 years of age, had any parity, and had a confirmed diagnosis of secondary infertility. The study occurred after getting permission from the institutional review board. Every participant in the study provided written informed consent, indicating their voluntary agreement to participate in the research and use their data for study purposes and publication. This study applied independent sample t-test and chi-square test. Working females, obese females, females living in the joint family system, cousin marriage, relationship difficulties with husband, violence during previous pregnancy by husband, history of diabetes, hypertension, polycystic ovary syndrome, pelvic inflammatory disease, endometriosis, uterine fibroids, menorrhagia, intermenstrual bleeding, history of abortion, history of breastfeeding, and history of urinary tract infection are associated with secondary infertility. The identified risk factors of secondary infertility are mostly modifiable, and managing these risk factors can prevent them.
Keywords: secondary infertility, socio-demographics, risk factors, pelvic inflammatory disease, polycystic ovarian syndrome.
Full Text:
PDFReferences
VANDER BORGHT M., and WYNS C. Fertility and infertility: Definition and epidemiology. Clinical Biochemistry, 2018, 62: 2-10. DOI: 10.1016/j.clinbiochem.2018.03.012.
IQBAL A., GILANI S.A., and HANIF A. Correlation between serum levers of follicle stimulating hormone and Graafian follicle vascularity on Doppler in infertile females of Lahore. Pakistan Armed Forces Medical Journal, 2021, 71(5), 1687. DOI: 10.51253/pafmj.v71i5.7233.
ABEBE M.S., AFEWORK M., and ABAYNEW Y. Primary and secondary infertility in Africa: systematic review with meta-analysis. Fertility Research and Practice, 2020, 6, Article number: 20. DOI: 10.1186/s40738-020-00090-3.
PUSPITANINGRUM D., and NUGRAHENI S. Determinants of Male and Female Infertility: A Systematic Review. Midwifery Journal, 2022, 11(2): 103-120. DOI: 10.26714/jk.11.2.2022.103-120.
AHMED H.M., KHAN M., YASMIN F., JAWAID H., KHALID H., SHIGRI A., NAWAZ F., and HASAN C.A. Awareness regarding causes of infertility among out-patients at a tertiary care hospital in Karachi, Pakistan. Cureus, 2020, 12(4), 7685. DOI: 10.7759/cureus.7685.
MIRZAEI M., NAMIRANIAN N., DEHGHANI FIROUZABADI R., and GHOLAMI S. The prevalence of infertility in 20-49 years women in Yazd, 2014-2015: A cross-sectional study. International Journal of Reproductive BioMedicine, 2018, 16(11): 683-688.
ABDULLAH A.A., AHMED M., and OLADOKUN A. Prevalence of infertility in Sudan: A systematic review and meta-analysis. Qatar Medical Journal, 2021, (3), 47. DOI: 10.5339/qmj.2021.47.
LIANG S., CHEN Y., WANG Q., CHEN H., CUI C., XU X., ZHANG Q., and ZHANG C. Prevalence and associated factors of infertility among 20-49 years old women in Henan Province, China. Reproductive Health, 2021, 18(1), Article number: 254. DOI: 10.1186/s12978-021-01298-2.
JABEEN F., KHADIJA S., and DAUD S. Prevalence of primary and secondary infertility. Saudi Journal of Medicine, 2022, 7(1): 22-28. DOI: 10.36348/sjm.2022.v07i01.004.
SAIF J, ROHAIL I, and AQEEL M. Quality of life, coping strategies, and psychological distress in women with primary and secondary infertility; a mediating model. Nature-Nurture Journal of Psychology, 2021, 1: 8-17.
ABDALLA N.M. Epidemiology of infertility in Gezira region, central of Sudan. Research Journal of Medical Sciences, 2011, 5(1): 56-60. DOI: 10.3923/rjmsci.2011.56.60.
AKHTAR S., NASREEN R., BIBI H., KHAN A.A., BAIG A.A., and RIFFAT N. Reproductive Features of Patients with Secondary Infertility. Pakistan Journal of Medical and Health Sciences, 2022, 16(10): 111-112. DOI: 10.53350/pjmhs221610111.
JAVAID S., MASTOI S.W., JAHAN E., KHALID S., JABEEN A., and MAHAJAN N. Prevalence of infertility and its causes in the population of Pakistan: A cross-sectional study. Annals of the Romanian Society for Cell Biology, 2022, 26(01): 129-133.
MORIDI A., ROOZBEH N., YAGHOOBI H., SOLTANI S., DASHTI S., SHAHRAHMANI N, and BANAEI M. Etiology and risk factors associated with infertility. International Journal of Women s Health and Reproduction Sciences, 2019, 7(3): 346-353. DOI: 10.15296/ijwhr.2019.57.
DESHPANDE P.S., and GUPTA A.S. Causes and Prevalence of Factors Causing Infertility in a Public Health Facility. Journal of Human Reproductive Sciences, 2019, 12(4): 287-293. DOI: 10.4103/jhrs.JHRS_140_18
ZHANG F., FENG Q., YANG L., LIU X., SU L., WANG C., YAO H., SUN D., and FENG Y. Analysis of the etiologies of female infertility in Yunnan minority areas. BMC Women's Health, 2021, 21, Article number: 88. DOI: 10.1186/s12905-021-01216-5.
DIABELKOVÁ J., RIMÁROVÁ K., URDZÍK P., DORKO E., HOUŽVIČKOVÁ A., ANDRAŠČÍKOVÁ Š., DRABIŠČÁK E., and ŠKREČKOVÁ G. Risk factors associated with low birth weight. Central European Journal of Public Health, 2022, 30: 43-49. DOI: 10.21101/cejph.a6883.
ENDALAMAW A., ENGEDA E.H., EKUBAGEWARGIES D.T., BELAY G.M., and TEFERA M.A. Low birth weight and its associated factors in Ethiopia: a systematic review and meta-analysis. Italian Journal of Pediatrics, 2018, 44(1): 1-12. DOI: 10.1186/s13052-018-0586-6.
MAHESHWARI A., HAMILTON M., and BHATTACHARYA S. Effect of female age on the diagnostic categories of infertility. Human Reproduction, 2008, 23(3): 538-542. DOI: 10.1093/humrep/dem431.
AZIZ N. Laparoscopic evaluation of female factors in infertility. Journal of College of Physicians and Surgeons Pakistan, 2010, 20(10): 649-652.
TALIB W., HAFEEZ M., IKRAM M., and SAEED M. Infertile female: laparoscopic evaluation. The Professional Medical Journal, 2007, 14(04): 562-566. DOI: 10.29309/TPMJ/2007.14.04.4805.
DEYHOUL N., MOHAMADDOOST T., and HOSSEINI M. Infertility-related risk factors: a systematic review. International Journal of Women's Health and Reproduction Sciences, 2017, 5(1): 24-29. DOI:10.15296/ijwhr.2017.05.
WANI Q.U.A, ARA R., DANGROO S., and BEIG M. Diagnostic laparoscopy in the evaluation of female factors in infertility in Kashmir Valley. International Journal of Women's Health and Reproduction Sciences, 2014, 2: 48-57. DOI: 10.15296/ijwhr.2014.08.
OMOKANYE L.O., IBRAHIM S., OLATINWO A.O., DUROWADE K.A., BILIAMINU S.A., and SALAUDEEN G.A. Female factors infertility: Laparoscopic evaluation at a public health facility in Ilorin, Nigeria. Indian Journal of Health Sciences and Biomedical Research, 2017, 10(3): 298-302. DOI:10.4103/kleuhsj.ijhs_503_16.
JAIN G., KHATUJA R., JUNEJA A., and MEHTA S. Laparoscopy: as a first line diagnostic tool for infertility evaluation. Journal of Clinical and Diagnostic Research, 2014, 8(10). DOI: 10.7860/JCDR/2014/9822.4929.
PANTASRI T., and NORMAN R.J. The effects of being overweight and obese on female reproduction: a review. Gynecological Endocrinology, 2014, 30(2): 90-94. DOI: 10.3109/09513590.2013.850660.
PFEIFER S., FRITZ M., MCCLURE R., ADAMSON G.D., BARNHART K., CATHERINO W., CEDARS M., COLLINS J., DAVIS O., SCHATTMAN G., GOLDBERG J., LIU J., THOMAS M., ORY S., RACOWSKY C., WIDRA E., LICHT M.K, GRACIA C., REBAR R., and LA BARBERA A. Multiple gestation associated with infertility therapy: an American Society for Reproductive Medicine Practice Committee opinion. Fertility and Sterility, 2012, 97(4): 825-834. DOI: 10.1016/j.fertnstert.2011.11.048.
YILMAZ F.Ç., SÜRÜCÜOĞLU M.S, and ÇAĞIRAN F.T. Association of obesity with primary and secondary infertility among infertile women in turkey: a cross-sectional study. Journal of Food and Nutrition Research, 2017, 5(4): 208-213.
CONG J., LI P., ZHENG L., and TAN J. Prevalence and risk factors of infertility at a rural site of Northern China. PloS One, 2016, 11(5), 0155563. DOI: 10.1371/journal.pone.0155563.
EDMONDS D.K. Dewhurst's textbook of obstetrics and gynaecology. Wiley Online Library; 2007. DOI: 10.1002/9780470753354.
DUN E.C., and NEZHAT C.H. Tubal factor infertility: diagnosis and management in the era of assisted reproductive technology. Obstetrics and Gynecology Clinics, 2012, 39(4): 551-566. DOI: 10.1016/j.ogc.2012.09.006.
NIKNEJADI M., HAGHIGHI H., AHMADI F., NIKNEJAD F., CHEHRAZI M., VOSOUGH A., and MOENIAN D. Diagnostic accuracy of transvaginal sonography in the detection of uterine abnormalities in infertile women. Iranian Journal of Radiology, 2012, 9(3): 139-144. DOI: 10.5812/iranjradiol.8063.
TAYDE P., SIRSAM S., and JATKAR P. Study of Causes and Outcome of Primary and Secondary Infertility at Tertiary Care Centre. Scholars International Journal of Obstetrics and Gynecology, 2019, 2: 229-234.
NAZ T., HASSAN L., GULMEEN N.F., and SULTAN S. Laparoscopic evaluation in infertility. Journal of College of Physicians and Surgeons Pakistan, 2009, 19(11): 704-707.
SULTANA A., TANIRA S., ADHIKARY S., KEYA K.A., and AKHTER S. Explained infertility among the couple attending the infertility unit of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh. Journal of Dhaka Medical College, 2014, 23(1): 114-120. DOI: 10.3329/jdmc.v23i1.22705
ORJI E. Comparative study of the impact of past pregnancy outcome on future fertility. Singapore Medical Journal, 2008, 49(12), 1021.
EMMANUEL M.O., OLAMIJULO J.A., and EKANEM E.E. Risk factors associated with secondary infertility in women of childbearing age: A matched case–control study. Tropical Journal of Obstetrics and Gynaecology, 2018, 35(3): 249-255. DOI: 10.4103/TJOG.TJOG_44_18.
Refbacks
- There are currently no refbacks.
