Addisu Dagne, Mekuriaw Begizew Yimenu, Berihun Erega Besfat, Yazie Ferede Wassie, Mihretie Gedefaye Nibret, Dagnew Enyew, Mitiku Assefa Kebie, Belachew Tegegne Wale, Mekie Maru
Debre Tabor University, Debre Tabor, Ethiopia.
PLoS One. 2025 May 16;20(5):e0323181. doi: 10.1371/journal.pone.0323181. eCollection 2025.
Infertility is a significant public health issue that affects couples worldwide. The impacts of infertility is notably higher in Ethiopia due to various factors, such as cultural stigmas surrounding infertility and inadequate infrastructure for diagnosis and treatment. Several fragmented primary studies have assessed factors associated with female infertility in Ethiopia; however, their findings have been controversial and inconclusive. This meta-analysis aimed to identify the factors associated with female infertility in Ethiopia.
A comprehensive search was conducted across multiple databases and search engines, including PubMed, African Journals Online, EBSCO, Google Scholar, and the Directory of Open Access Journals. Additionally, studies were searched from the institutional repositories of Ethiopian universities. Data analysis was performed using Stata version 17. The quality of the included studies was evaluated using the Newcastle-Ottawa quality assessment instrument. Heterogeneity and publication bias were assessed using I² and Egger's tests, respectively. A random effects model was employed to identify factors associated with female infertility. The PROSPERO registration number for this meta-analysis was CRD42024525437.
Six studies were included in the analysis. Factors associated with female infertility included having multiple sexual partners (odds ratio [OR] = 4.31, 95% confidence interval [CI] = 3.46-5.16), a history of sexually transmitted diseases (OR = 2.76, 95% CI = 1.61-3.91), alcohol-abusing partners (OR = 1.57, 95% CI = 1.25-1.89), Khat-abusive partners (OR = 1.85, 95% CI = 1.36-2.35), and women's age over 35 years (OR = 2.07, 95% CI = 1.32-2.81).
Having multiple sexual partners, a history of sexually transmitted diseases, an alcohol-abusing partner, a khat-abusing partner, and being over the age of 35 were significantly associated with female infertility in Ethiopia. Addressing these risk factors through education, early intervention, lifestyle modifications, and partner involvement can help reduce the burden of infertility and improve the chances of successful conception. The findings underscore the need for further research on understudied factors contributing to female infertility in Ethiopia, including immune function, psychological health, environmental exposures, as well as endocrinological and gynecological conditions.
不孕症是一个重大的公共卫生问题，影响着全球的夫妇。由于各种因素，如围绕不孕症的文化耻辱感以及诊断和治疗基础设施不足，埃塞俄比亚不孕症的影响尤为严重。埃塞俄比亚有几项零散的初步研究评估了与女性不孕症相关的因素；然而，他们的研究结果一直存在争议且尚无定论。这项荟萃分析旨在确定埃塞俄比亚与女性不孕症相关的因素。
在多个数据库和搜索引擎中进行了全面搜索，包括PubMed、非洲期刊在线、EBSCO、谷歌学术和开放获取期刊目录。此外，还从埃塞俄比亚大学的机构知识库中搜索了研究。使用Stata 17版进行数据分析。使用纽卡斯尔-渥太华质量评估工具评估纳入研究的质量。分别使用I²和Egger检验评估异质性和发表偏倚。采用随机效应模型来确定与女性不孕症相关的因素。该荟萃分析的PROSPERO注册号为CRD42024525437。
六项研究纳入分析。与女性不孕症相关的因素包括有多个性伴侣（优势比[OR]=4.31，95%置信区间[CI]=3.46-5.16）、性传播疾病史（OR=2.76，95%CI=1.61-3.91）、酗酒伴侣（OR=1.57，95%CI=1.25-1.89）、咀嚼恰特草的伴侣（OR=1.85，95%CI=1.36-2.35）以及35岁以上的女性（OR=2.07，95%CI=1.32-2.81）。
在埃塞俄比亚，有多个性伴侣、性传播疾病史、酗酒伴侣、咀嚼恰特草的伴侣以及年龄超过35岁与女性不孕症显著相关。通过教育、早期干预、生活方式改变和伴侣参与来解决这些风险因素，有助于减轻不孕症负担并提高成功受孕的几率。研究结果强调需要对埃塞俄比亚女性不孕症的未充分研究因素进行进一步研究，包括免疫功能、心理健康、环境暴露以及内分泌和妇科疾病。
