Prevalence of infertility and the effect of covariates on survival time to pregnancy: A nationally representative population based cross sectional study

Abstract

Objective

This study sought to estimate population level prevalence of infertility and explored whether time to pregnancy is related to selected factors.

Methods

This study's analysis was based on data collected from 2081 women who were sampled from participants of the 2016 Ethiopia Demographic and Health Survey based on risk of pregnancy criteria: age between 15 and 49 years, currently married or cohabitating, sexually active, not used contraception method during the 5 years before interview, not menopausal, and not pregnant. We used a current duration (CD) approach in which for each woman we calculated the length of time-at-risk of pregnancy (CD value) in months. A parametric survival model was fitted to CD values from which the median time to pregnancy (TTP) and prevalence of infertility were estimated. To explore variables associated with a longer TTP accelerated failure time, regression models were built to estimate time ratios.

Results

The median TTP was 4 months (95% confidence interval [CI] 3.9–4.1). The 12-month prevalence of overall, primary, and secondary infertility were 29.5% (95% CI 27.50–31.47), 31.1% (95% CI 27.85–34.48), and 27.7% (95% CI 25.30–30.23), respectively. A longer TTP was observed for women aged 35 to 49 (P = 0.001), nulliparous (P = 0.00), when the usual residence of the husband is outside the home (P = 0.001), for women who want to give birth soon (P = 0.00), for cigarette smokers (P = 0.027), for rich women (P = 0.002), and for tertiary (P = 0.00) and primary educated women (P = 0.00).

Conclusion

This study suggests 30% of reproductive-age women experience infertility, which indicates that large numbers of Ethiopian women need fertility services.