Legese Nanati, Tura Abera Kenay, Roba Kedir Teji, Demeke Henok
School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Department of Obstetrics and Gynecology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
PLoS One. 2023 Oct 12;18(10):e0291912. doi: 10.1371/journal.pone.0291912. eCollection 2023.
Despite having a high fertility rate, low-resource countries are also home to couples with infertility problems. Although many couples are suffering from the psychological impacts of infertility, its level and determinants are not adequately known. The main objective of this study is to assess the prevalence and factors associated with infertility among couples in Ethiopia using the 2016 Ethiopian Demographic and Health Survey (EDHS) data.
The study employed a cross-sectional study design extracting variables from the 2016 EDHS. The study included all married or cohabitating women aged 15 to 49 years in the Couples Recode (CR) file data set. Weighted samples of 6141 respondents were analyzed. We used Stata 14 software for analyzing the data. The association of selected independent variables with primary, secondary, and total infertility was analyzed using a logistic regression model. We presented the results using an adjusted odds ratio (AOR) with a 95% confidence interval (CI) and a p-value <0.05 as a cut-off point for declaring statistical significance.
The prevalence of infertility in the past 12 months was 24.2% (95% CI: 23.1-25.3%), of which the majority (90.7%) was secondary infertility. Greater than 35 years of age (AOR = 2.45, 95% CI (1.58-3.79)), rural residence (AOR = 1.06, 95% CI (1.01-1.39)), smoking (AOR = 2.29, 95% CI (1.39-3.77)), and <18.5 Body Mass Index (BMI) (AOR = 1.71, 95% CI (1.43-2.04)) were significantly associated with infertility. Conversely, infertility was less likely among women with formal education and better wealth index. Primary infertility was significantly higher among women whose partners drink alcohol (AOR = 1.55; 95% CI 1.06-2.28)) and chew khat (AOR = 1.62; 95% CI (1.12-2.36)). Secondary infertility was significantly higher among women with <18.5 BMI (AOR = 1.59, 95% CI (1.37-1.84)), >30 BMI (AOR = 1.54; 95% CI 1.01-2.35)), and <15 years of age at first birth (AOR = 1.40; 95% CI 1.15-1.69)).
More than one in five couples in Ethiopia has an infertility problem. Both male and female-related factors are associated with infertility. Primary infertility was significantly higher among women whose partner chews khat and drinks alcohol. Secondary infertility was significantly associated with being underweight, obese, smoking, and young age at first birth. Hence, taking action on preventable factors is the most critical treatment approach and will improve the health status of the couples in other ways.
尽管资源匮乏国家的生育率较高，但这些国家也存在不孕不育问题的夫妇。虽然许多夫妇正遭受不孕不育带来的心理影响，但其程度和决定因素尚不完全清楚。本研究的主要目的是利用2016年埃塞俄比亚人口与健康调查（EDHS）数据，评估埃塞俄比亚夫妇中不孕不育的患病率及其相关因素。
本研究采用横断面研究设计，从2016年EDHS中提取变量。研究纳入了夫妇编码（CR）文件数据集中所有年龄在15至49岁的已婚或同居女性。对6141名受访者的加权样本进行了分析。我们使用Stata 14软件进行数据分析。使用逻辑回归模型分析选定自变量与原发性、继发性和总不孕不育之间的关联。我们以调整后的优势比（AOR）、95%置信区间（CI）和p值<0.05作为判断统计学显著性的临界点来呈现结果。
过去12个月不孕不育的患病率为24.2%（95%CI：23.1 - 25.3%），其中大多数（90.7%）为继发性不孕不育。年龄大于35岁（AOR = 2.45，95%CI（1.58 - 3.79））、农村居住（AOR = 1.06，95%CI（1.01 - 1.39））、吸烟（AOR = 2.29，95%CI（1.39 - 3.77））以及体重指数（BMI）<18.5（AOR = 1.71，95%CI（1.43 - 2.04））与不孕不育显著相关。相反，接受正规教育且财富指数较高的女性不孕不育的可能性较小。伴侣饮酒（AOR = 1.55；95%CI为1.06 - 2.28）和咀嚼恰特草（AOR = 1.62；95%CI（1.12 - 2.36））的女性原发性不孕不育显著更高。BMI<18.5（AOR = 1.59，95%CI（1.37 - 1.84））、BMI>30（AOR = 1.54；95%CI为1.01 - 2.35）以及首次生育年龄<15岁（AOR = 1.40；95%CI为1.15 - 1.69）的女性继发性不孕不育显著更高。
埃塞俄比亚超过五分之一的夫妇存在不孕不育问题。男性和女性相关因素均与不孕不育有关。伴侣咀嚼恰特草和饮酒的女性原发性不孕不育显著更高。继发性不孕不育与体重过轻、肥胖、吸烟以及首次生育年龄较小显著相关。因此，针对可预防因素采取行动是最关键的治疗方法，并且将在其他方面改善夫妇的健康状况。
