Factors associated with infertility among married women in Rajshahi City, Bangladesh 10.55131/jphd/2022/200311
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Infertility has become a growing problem among reproductive aged women in both developing and developed countries. Recent statistics indicate a significant number of married couples suffering from infertility and visiting infertility centers has increased in Bangladesh. Therefore, this study aims to identify the factors associated with infertility in Bangladeshi women. This is a retrospective study and data were collected from 450 reproductive aged women purposively using a structured questionnaire from an infertility center in Rajshahi City, Bangladesh. Univariate, bivariate and multivariate analyses were used to reach the objectives. The results revealed that most respondents (58.2%) were overweight and obese by measuring Body Mass Index (BMI). Age, age at first marriage, BMI, duration of contraceptive use, husband’s diabetes status, and husband’s drug addiction were found significantly associated with infertility. Infertility cases were found to be higher among women aged ≥30 years (OR: 10.16; 95% CI: 2.70-38.2; p <0.001). Overweight and obese women are 2.33 times more likely to be infertile compared to underweight women (OR: 2.33; 95% CI: 0.12-0.57; p <0.008). The couple who use the contraceptive for 2 years and above are around 2 times more likely to be infertile compared to those using it for months (OR: 1.99; 95% CI: 0.97-4.09; p <0.059). The women whose husbands use drugs are 5.51 times at higher risk to be infertile compared to those women whose husbands did not take drugs (OR: 5.51; 95% CI: 2.35-12.90; p <0.000). Thus, child expected couples should consider the aforesaid factors. As infertility has a complex relation with basic risk factors, the study findings may help the health policy researchers to address more underlying risk factors of infertility in their further studies. Moreover, these results could be carefully considered by the government and stakeholders to find effective interventions and solutions to the infertility problem in Bangladesh, especially in Rajshahi City, Bangladesh.
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World Health Organization (WHO). International Classification of Diseases, 11th Revision (ICD-11) Geneva: WHO; 2018.
Agarwal A, Mulgund A, Hamada A, Chyatte MR. A unique view on male infertility around the globe. Reprod Biol Endocrinol 2015;13:37. doi: 10.1186/s12958-015-0032-1
Bayu D, Egata G, Kefale B, Jemere T. Determinants of Infertility among Married Women Attending Dessie Referral Hospital and Dr. Misganaw Gynecology and Obstetrics Clinic, Dessie, Ethiopia. Int J Reprod Med 2020:1540318. doi: 10.1155/2020/ 1540318
Rutstein SO, Shah IH. Infecundity infertility and childlessness in developing countries. Geneva: World Health Organization; 2004.
Boivin J, Bunting L, Collins JA, Nygren KG. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Hum Reprod 2007;22(6):1506-12. doi: 10.1093/ humrep/dem046.
Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA. National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med 2012;9(12): e1001356. doi: 10.1371/journal.pmed. 1001356.
Pidsley R. Experts warn of rising infertility in developing countries. BioNews; 2010.
Inhorn MC, Patrizio P. Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century. Hum Reprod Update 2015;21(4):411-26. doi: 10.1093/humupd/dmv016.
Datta J, Palmer MJ, Tanton C, Gibson LJ, Jones KG, Macdowall W, et al. Prevalence of infertility and help seeking among 15000 women and men. Hum Reprod 2016 Sep;31(9):2108-18. doi: 10.1093/humrep/dew123.
Khairwa A, and Kumar D. Whom to Blame For Infertility: Semen Analysis of Men from 70 Infertile Couples. Epidemiology 2018;8(4):361. doi: 10.4172/2161-1165.1000361.
Homan GF, Davies M, and Norman R. The impact of lifestyle factors on reproductive performance in the general population and those undergoing infertility treatment: a review. Hum Reprod Update 2007;13(3):209-23. doi: 10.1093/humupd/dml056.
Jumayev I, Harun-Or-Rashid M, Rustamov O, Zakirova N, Kasuya H, Sakamoto J. Social correlates of female infertility in Uzbekistan. Nagoya J Med Sci 2012;74:273-83.
Donkor ES and Sandall J. The impact of perceived stigma and mediating social factors on infertility-related stress among women seeking infertility treatment in Southern Ghana. Soc Sci Med, 2007;65(8):1683-94. doi: 10.1016/j.socscimed.2007.06.003.
Nahar P, Richters A. Suffering of childless women in Bangladesh: the intersection of social identities of gender and class. Anthropol Med 2011;18(3):327-38. doi: 10.1080/13648470.2011.615911.
Vaessen M. Childlessness and infecundity WFS Comparative Studies. Series 31.Voorburg, The Netherlands: Cross national Summaries; 1984.
Kumar D. Prevalence of female infertility and its socioeconomic factors in Tribal communities of Central India. Rural Remote Health 2007;7(2):456.
Hollos M, and Larsen U. Motherhood in sub-Saharan Africa: the social consequences of infertility in an urban population in northern Tanzania. Cult Health Sex 2008;10(2):159-73. doi: 10.1080/13691050701656789.
Sultana A, Tanira S, Adhikary S, Keya KA, 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):114-20. doi: :10.3329/jdmc.v23i1.22705.
Hossain SM, Khaliduzzaman SM, Huq S, Sharmin UH, Eusufzai SZ, Zamayet NB. Evaluation of Pattern of Infertility among the Patients of a Selected Infertility Center in Dhaka, Bangladesh. IOSR Journal of Nursing and Health Science (IOSR-JNHS) e-ISSN. 2016:2320-1959. doi: 10.9790/1959-0504032832.
Neupane P, Sharma D, Panta PP, Aryal B, Poudel T, Amgain K. Causes of Infertility amongst Couples Visited at Infertility Centre Kathmandu, Nepal. Journal of Karnali Academy of Health Sciences. 2019;2(2). doi: https://doi. org/10.3126/jkahs.v2i2.25180.
Ramos RR, Gutiérrez GR, Monroy IA, Sánchez HG. Risk factors associated to female infertility. Ginecol Obstet Mex 2008;76(12):717-21.
Liang S, Chen Y, Wang Q, Chen H, Cui C, Xu X, et al. Prevalence and associated factors of infertility among 20–49 year old women in Henan Province, China. Reprod Health 2021;18(1):254. doi: 10.1186/s12978-021-01298-2.
Cong J, Li P, Zheng L, Tan J. Prevalence and risk factors of infertility at a rural site of Northern China. PloS one 2016;11(5):e0155563. doi: 10.1371/journal.pone.0155563.
Sami N, Ali TS, Wasim S, Saleem S. Risk factors for secondary infertility among women in Karachi, Pakistan. PloS one. 2012;7(4):e35828. doi: 10.1371/journal.pone.0035828.
Rhoton-Vlasak A. Infections and infertility. Primary Care Update for Ob/Gyns 2000; 7(5):200-6. doi: 10.1016/s1068-607x(00)00047-0.
Pellati D, Mylonakis I, Bertoloni G, Fiore C, Andrisani A, Ambrosini G, et al. Genital tract infections and infertility. Eur J Obstet Gynecol Reprod Biol 200;140(1):3-11. doi: 10.1016/j.ejogrb.2008.03.009.
Sharma R, Biedenharn KR, Fedor JM, Agarwal A. Lifestyle factors and reproductive health: taking control of your fertility. Reprod Biol Endocrinol 2013;11:66. doi: 10.1186/1477-7827-11-66.
Tabernero-Rico PM, Garcia-Velasco JA. Observational Study of the Social Determinants of Health in Subfertile versus Nonsubfertile Women. J Hum Reprod Sci 2019;12(3):240-246. doi: 10.4103/jhrs.JHRS_20_19.
Pai MO, Venkatesh S, Gupta P. The role of infections in infertility: A review. IJAM 2020; 6(3):189-96. doi: 10.4103/IJAM.IJAM_44_19.
Vahidi S, Ardalan A, Mohammad K. Prevalence of primary infertility in the Islamic Republic of Iran in 2004-2005. Asia Pac J Public Health 2009;21(3):287-93. doi: 10.1177/ 1010539509336009.
Nahar MZ, Zahangir MS, Shafiqul Islam SM. Age at first marriage and its relation to fertility in Bangladesh. Chinese Journal of Population Resources and Environment 2013; 11(3):227-35. doi: https://doi.org/ 10.1080/10042857.2013.835539.
Yland JJ, Bresnick KA, Hatch EE, Wesselink AK, Mikkelsen EM, Rothman KJ, et al. Pregravid contraceptive use and fecundability: prospective cohort study. BMJ 2020;371:m3966. doi: 10.1136/ bmj.m3966.
Roy T K, Halder N, Singh BP. Risk Factors of Infertility in Bangladesh: A Poisson Regression Analysis. Risk 2021;1(1)79-86.
Chowdhury MA, Haque MM, Chowdhury S, Prodhania MS. Determinants of infertility among couples seeking treatment in a selected clinic in Dhaka City. Chatt Maa Shi Hosp Med Coll J 2014;13(3):42-5. doi: https://doi.org/10.3329/cmoshmcj.v13i3.21021.
Siddiqua F, Sultana S, Nesa M, Saw A, Hossain MG, Mahdi SHA. Study on infertility and related factors; 2019.
Bangladesh Bureau of Statistics (BBS). Population and Housing Census 2011. BBS; Statistics and Informatics division, Ministry of Planning, Government of the People’s Republic of Bangladesh; 2012.
Cochran WG. Sampling Techniques. The Third Edition. John Wiley & Sons, Inc; 1977.
Mokhtar S, Hassan HA, Mahdy N, Elkhwsky F, Shehata G. Risk factors for primary and secondary female infertility in Alexandria: a hospital-based case-control study. JMRI 2006; 27:255-61.
International Institute for Population Sciences and ORC Macro. Report of the National Family Health Survey (NFHS-III): Mumbai: IIPS; 2006.
Tabong PTN, Adongo PB. Infertility and childlessness: a qualitative study of the experiences of infertile couples in Northern Ghana. BMC Pregnancy Childbirth 2013:13(72). doi: https:// doi.org/10.1186/1471-2393-13-72.
Imani B, Eijkemans MJ, te Velde ER, Habbema JD, Fauser BC. Predictors of patients remaining anovulatory during clomiphene citrate induction of ovulation in normogonadotropic oligoamenorrheic infertility. J Clin Endocrinol Metab 1998; 83(7):2361-65. doi: 10.1210/jcem.83.7.4919.
Seddigheh E, Mouloud AD, Zahra B, and Hamid S. Physical activity and body mass index among women who have experienced infertility. Arch Med Sci 2013;9:499-505. doi: 10.5114/ aoms.2013.35342.
Dağ ZÖ, Dilbaz B. Impact of obesity on infertility in women. J Turk Ger Gynecol Assoc 2015;16(2):111-7. doi: 10.5152/jtgga.2015.15232.
Silvestris E, de Pergola G, Rosania R, Loverro G. Obesity as disruptor of the female fertility. Reprod Biol Endocrinol. 2018;16(1):22. doi: 10.1186/s12958-018-0336-z.
Livshits A, Seidman DS. Fertility issues in women with diabetes. Womens Health (Lond) 2009;5(6):701-7. doi: 10.2217/whe.09.47.
Szaboova R, Devendra S. Infertility in a young woman with Type 2 diabetes. London J Prim Care (Abingdon). 2015;7(3):55-7. doi: 10.1080/17571472.2015.11494378.
Condorelli RA, La Vignera S, Mongioì LM, Alamo A, Calogero AE. Diabetes Mellitus and Infertility: Different Pathophysiological Effects in Type 1 and Type 2 on Sperm Function. Front Endocrinol (Lausanne). 2018;9:268. doi: 10.3389/fendo.2018.00268.
Saquib N, Saquib J, Ahmed T, Khanam MA, Cullen MR. Cardiovascular diseases and type 2 diabetes in Bangladesh: a systematic review and meta-analysis of studies between 1995 and 2010. BMC Public Health. 2012; 12:434. doi: 10.1186/1471-2458-12-434.
International Diabetes Federation (IDF). Country estimates table 2011. IDF diabetes atlas. 6th ed. 2012.