Risk factors for primary and secondary female infertility in alexandria : A hospital based case control study

Abstract EN

Introduction : Female infertility either primary or secondary type is a multifactorial condition.

It constitutes a worldwide public health problem that has gained much concern during the past two decades.

Cases and risk factors of infertility can be classified into: genital, endocrinal, developmental and general factors.

Methods and Subjects: we conducted a hospital based case control study to identify and quantify the risk factors for primary and secondary infertility in Alexandria.

Cases and controls (N = 215 each); infertile females were selected at random from infertility clinic.

An age matched 215 fertile females were enrolled as controls from family planning clinic from the same Hospital.

A pre-designed questionnaire was utilized to collect data about the sociodemographic lifestyle, medical, surgical history, detailed gynecological and obstetrical history.Univariate and multivariate logistic regression analysis were used to assess the magnitude of association at 5% level of significance.

Results The present study included 172 cases (80%) with primary infertility and 43 cases (20%) with secondary infertility admitted to the study center during 2002-2005.

The mean age of cases was 32.1 ± 5.24 years and for controls it was 31.8 ± 5.54 years.

The significant predictors for primary infertility by multiple logistic regression were : age of menarche, family history of infertility, STI and PCOS.

The corres-ponding odds ratios were (OR = 21.9, CI = 1.1-85.8), OR = 18.9, CI = 3.3-43.0), OR = 1.6, CI = 1.1-5.6) and (OR = 28.3, CI = 5.0-65.7), respectively.

For secondary infertility, the only significant predictor was STI (OR = 3.6, CI = 2.3-41.0).

The highest reported population attributable risk percentages were : for primary infertility were as PCOS as 19.4% followed by irregular menstruation as 15.9% then STI as 7.9% and finally surgical operation as 4.6 %.

The highest calculated PAR% in secondary infertility were irregular menses as 19.2% followed by 15.4% for PCOS then 14.1 % for STI and 6.5% for surgical operation .The findings of the study agreed with other mostly recent studies, that early detection and management of PCOS, STI and irregular cycles are important for controling infertility.