Abstract
BACKGROUNDInfertility is a practical concern of Africans due to social disgrace and exclusion. This meta-analysis aims to analyze the proportion of primary and secondary infertility and identify the etiologic factors based on the studies conducted in Africa.METHODSAn internet-based search was conducted on the following databases; PubMed/Medline, EMBASE, Cochrane library, and google scholar. Both population and institution-based studies conducted among African couples, males, and females were included. Data extraction and critical appraisal of the articles were done by two independent investigators. Meta-analysis using a random effect model was conducted by Stata version 14. Forest plot, heterogeneity test, and funnel plot for publication bias were performed.RESULTSThe pooled proportion of primary and secondary infertility in Africa was 49.91% (I2 = 98.7, chi-square = 1509.01, degree of freedom = 19 and p < 0.001) and 49.79% (I2 = 98.7, chi-square = 1472.69, degree of freedom = 19 and p < 0.001) respectively. The pooled prevalence of the causes of infertility indicated that 54.01% and 22.26% of the infertility cases were respectively due to female and male-related problems. In 21.36% of infertility cases, both sexes were affected, while 10.4% of the causes of infertility were unexplained. The pooled prevalence of mostly reported causes of male infertility was 31% (oligospermia), 19.39% (asthenozoospermia), and 19.2% (varicocele). The most commonly identified causes of female infertility were pelvic inflammatory disease, tubal factors, and abortion with a pooled prevalence of 39.38%, 39.17%, and 36.41% respectively.ConclusionsIn Africa, the proportion of primary and secondary infertility is approximately equal. Infertility is mostly due to female-related causes like; pelvic inflammatory diseases, uterine tube related problems, and abortion. Oligospermia, asthenozoospermia, and varicocele were the commonest causes of male-related infertility. It is suggested that interpretation and utilization of these findings should consider the presence of substantial heterogeneity between the included studies.
Highlights
The clinical definition of infertility is an inability to be pregnant after 12 months or more of regular unprotected coitus [1]
Infertility is mostly due to female-related causes like; pelvic inflammatory diseases, uterine tube related problems, and abortion
Oligospermia, asthenozoospermia, and varicocele were the commonest causes of male-related infertility
Summary
The clinical definition of infertility is an inability to be pregnant after 12 months or more of regular unprotected coitus [1]. From the demographer’s point of view, infertility is defined as the absence of live birth in a woman of reproductive age (15–49 years) with regular unprotected sexual. Ovulatory disorder, contraception use, and sociocultural factors are the causes of female infertility. Genetic and environmental factors and infections can affect male fertility. These could lead to impaired sperm cell production, sperm transportation, and sexual habit which end up with infertility [6]. Infertility is a practical concern of Africans due to social disgrace and exclusion.
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