Definition Of Infertility Research Articles

The varying estimation of infertility in Ethiopia: the need for a comprehensive definition

BackgroundInfertility is a marginalized sexual and reproductive health issue in low-resource settings. Globally, millions are affected by infertility, but the lack of a universal definition makes it difficult to estimate the prevalence of infertility at the population level. Estimating the prevalence of infertility may inform targeted and accessible intervention, especially for a resource-limited country like Ethiopia. This study aims to estimate the prevalence of female infertility in Ethiopia using the Demographic and Health Survey (DHS) through two approaches: (i) the demographic approach and (ii) the current duration approach.MethodsData from 15,683 women were obtained through the 2016 Ethiopian DHS. The demographic approach estimates infertility among women who had been married/in a union for at least five years, had never used contraceptives, and had a fertility desire. The current duration approach includes women at risk of pregnancy at the time of the survey and determines their current length of time-at-risk of pregnancy at 12, 24, and 36 months. Logistic regression analysis estimated the prevalence of infertility and factors associated using the demographic approach. Parametric survival analysis estimated the prevalence of infertility using the current duration approach. All estimates used sampling weights to account for the DHS sampling design. STATA 14 and R were used to perform the statistical analysis.ResultsUsing the demographic definition, the prevalence of infertility was 7.6% (95% CI 6.6–8.8). When stratified as primary and secondary infertility, the prevalence was 1.4% (95% CI 1.0-1.9) and 8.7% (95% CI 7.5–10.1), respectively. Using the current duration approach definition, the prevalence of overall infertility was 24.1% (95% CI 18.8–34.0) at 12-months, 13.4% (95% CI 10.1–18.6) at 24-months, and 8.8% (95% CI 6.5–12.3) at 36-months.ConclusionThe demographic definition of infertility resulted in a lower estimate of infertility. The current duration approach definition could be more appropriate for the early detection and management of infertility in Ethiopia. The findings also highlight the need for a comprehensive definition of and emphasis on infertility. Future population-based surveys should incorporate direct questions related to infertility to facilitate epidemiological surveillance.

Factors associated with female infertility in Ukraine: results a multicenter study.

Aim: To determine the current prevalence of female infertility and characterize and identify risk factors associated with infertility in Ukraine. Materials and Methods: Multicenter prospective cohort study was conducted from January 2021 to December 2023 in twelve medical centers from nine regions of Ukraine. Definitions of infertility were adapted from the World Health Organization. According to the data collected from questionnaire, participants were divided into infertile and fertile groups and analyzed associated factors. Results: Among all the 7,618 participants in this study, the prevalence of female infertility was 24.3%. The prevalence of primary infertility was 5.9%, and the prevalence of secondary infertility was 18.4%. In logistic multivariate regression analyses, female infertility was associated with age of women (p<0.001), age of first sexual intercourse (p<0.001), history of gynecological surgery (p<0.001), marital status (p<0.001), age of marriage (p<0.001), decreased ovarian reserve (DOR) (p=0.006), family history of infertility (p<0.001), history of cervicitis (p=0.007), history of surgical abortion (p<0.001), history of endometritis (p=0.027), bacterial vaginosis (p=0.023), and aerobic vaginitis (< 0.001). Conclusions: Our data suggest a high prevalence of female infertility in Ukraine. The prevalence of secondary infertility was higher than primary infertility. Age of women, age of first sexual intercourse, history of gynecological surgery, marital status, age of marriage, DOR, family history of infertility, history of cervicitis, history of surgical abortion, history of endometritis, bacterial vaginosis, and aerobic vaginitis were associated with infertility.

An unbiased approach of molecular characterization of the endometrium: toward defining endometrial-based infertility.

Infertility is a complex condition affecting millions of couples worldwide. The current definition of infertility, based on clinical criteria, fails to account for the molecular and cellular changes that may occur during the development of infertility. Recent advancements in sequencing technology and single-cell analysis offer new opportunities to gain a deeper understanding of these changes. The endometrium has a potential role in infertility and has been extensively studied to identify gene expression profiles associated with (impaired) endometrial receptivity. However, limited overlap among studies hampers the identification of relevant downstream pathways that could play a role in the development of endometrial-related infertility. To address these challenges, we propose sequencing the endometrial transcriptome of healthy and infertile women at the single-cell level to consistently identify molecular signatures. Establishing consensus on physiological patterns in endometrial samples can aid in identifying deviations in infertile patients. A similar strategy has been used with great success in cancer research. However, large collaborative initiatives, international uniform protocols of sample collection and processing are crucial to ensure reliability and reproducibility. Overall, the proposed approach holds promise for an objective and accurate classification of endometrial-based infertility and has the potential to improve diagnosis and treatment outcomes.

How Far Should We Investigate the Male Causes in Unexplained Infertility?

According to a recent report by the Guideline Development Group of the ESHRE, the definition of Unexplained Infertility (UI) is ‘infertility in couples with apparently normal ovarian function, fallopian tubes, uterus, cervix and pelvis, age [Formula: see text]40 years and with adequate coital frequency; and apparently normal testicular function, genito-urinary anatomy and a normal ejaculate.’ This is anchored with the ICMART definition of infertility, where couples should have at least 12 months of regular, unprotected sexual intercourse before investigations are initiated. Since Unexplained Infertility is a diagnosis by exclusion, apart from evaluating female causes, it seems important that in evaluating male contributions to the UI, all necessary tests need to be carried out. Unfortunately, there are no robust standardized methods for establishing etiologic diagnosis in the male partner and that in some patients, underlying sperm dysfunction may not be detected during a routine assessment of the ejaculate, which may appear to be normal using the 2021 WHO standards. It is possible that some adverse reproductive outcomes that have been identified during medical and reproductive history examination may require the use of further tests procedures specified in the latest WHO manual to assess sperm function. However, these tests have a research status only or are not regarded for routine use in clinical practice until sound evidence is developed. These tests include testicular imaging, anti-sperm antibodies, sperm DNA fragmentation, sperm chromatin condensation, sperm aneuploidy screening, serum hormone testing, semen HPV testing, and semen microbiology testing all of which were found not routinely indicated based on current evidence when semen was found to be normal using the WHO 2021 semen standards. In summary, in evaluating male causes in unexplained infertility, there are no robust data to support the recommendation that additional tests about the male reproductive function may routinely be carried out when semen analysis based on the 2021 WHO standard is normal. However, additional tests may be carried out when adverse reproductive outcomes and findings in the medical and reproductive history may require the use of these further tests especially when there are no findings on the female side.

Minor changes in the incidence of primary and secondary involuntary childlessness across birth cohorts 1916 to 1975, but major differences in treatment success.

There have been tremendous advances in assisted reproductive technologies (ARTs) over the past 50 years. The present study assessed infertility outcomes among women of reproductive age during this period. The seventh survey of the Tromsø Study (Tromsø7, 2015-16) recruited Tromsø residents aged 40-98 years. The questionnaire collected information on sociodemographics and infertility, as well as data from a wide range of validated health questionnaires. Primary involuntary childlessness was defined as reporting one or more of the following: the clinical definition of infertility (i.e., infertility period of >1 year), infertility examination, use of ART, and/or the birth of a child conceived during ART. Women with secondary involuntary childlessness were those who reported infertility experience and had least one naturally conceived child. Parous women without infertility experience were classified as fertile, and nulliparous women without infertility experience as voluntarily childless. The main exposure was birth cohort (1916-35, aged 80-98 years; 1936-45, aged 70-79 years; 1946-55, aged 60-69 years; 1956-65, aged 50-59 years; 1966-75, aged 40-49 years). The incidence of primary involuntary childlessness was significantly higher in the 1956-75 cohort (6.0%; 95% CI: 5.4-6.6) than the 1916-55 cohort (3.7%; 95% CI: 3.2-4.3). The incidence of secondary involuntary childlessness was higher than that of primary involuntary childlessness across all birth cohorts and was highest for the 1966-75 cohort (10%), with no differences observed across the other birth cohorts (6-7%). An increasing proportion of women from the oldest to the youngest birth cohorts reported infertility examination and ART. ART success increased substantially with time, reaching 58% for primary and 46% for secondary infertility in the 1966-75 cohort. Voluntarily childless women comprised 5-6% of the 1916-55 cohort and 9-10% of the 1956-75 cohort. There were minor differences in the incidence of primary and secondary involuntary childlessness across the 1916-75 cohorts. Advances in ART over the past 50 years comprised 2.0% and 3.3% of population growth in the 1956-65 and 1966-75 cohorts, respectively: a remarkable achievement.

WHO fact sheet on infertility (definition of infertility), published in Global Reproductive Health (2021)

To the Editor, I have read the article entitled “WHO fact sheet on infertility” published in Global Reproductive Health (2021), this was initially published by the World Health Organization (WHO) International Classification of Diseases, 11th Revision (ICD-11) Geneva: WHO 2018. This article has given a concise definition of infertility as “Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse.” This has been a helpful guide in the diagnosis, classification, treatment, and epidemiological survey of infertility all over the world. I will like to thank WHO for this definition and make some contribution based on my experience. The definition focused on the individual rather than the union between the couple or the 2 individual that is trying to reproduce or have a child. A couple can be infertile due to pathology in one of the 2 members or due to lack of compensation from other members of the union thus labeled infertile. However, each member may have a chance of having a pregnancy if he or she had unprotected intercourse with another individual for the specified time frame and such relationship will not be clinically presented as infertile. The definition of infertility would have been more encompassing if it is based on couple or union rather than considering individual entities. The individual involved should be labeled as “suspected infertile” as there is the possibility of pregnancy if he or she has unprotected intercourse over the time frame of a year with another individual. A critical look at this suggestion can change the orientation, psychology, management, and every other factor related to infertility.

Defining infertility: a qualitative interview study of patients and physicians

ABSTRACT Purpose To investigate if infertility patients and physicians apply a traditional biomedical model of disease in their conceptualisation of infertility, examine any contradictions and conflicts in conceptualisations, and examine areas of concordance and discordance between physicians and patients. Methods Semi-structured interviews were conducted with 20 infertility patients and 18 infertility physicians between September 2010 and April 2012. Interviews were analysed qualitatively to determine physician and patient conceptualisations of infertility, reactions to the definition of infertility as a disease, and potential benefits and concerns related to application of a disease label to the condition. Results Most physicians (n = 14/18) and a minority of patients (n = 6/20) were supportive of defining infertility as a disease. Many of the patients who agreed with classifying infertility as a disease expressed that they had not personally defined it as such previously. Physicians (n = 14) and patients (n = 13) described potential benefits of a disease label, including increases in research funding, insurance coverage, and social acceptability. Some patients (n = 10) described potential stigma as a negative consequence. When describing appraisals of infertility, both physicians (n = 7) and patients (n = 8) invoked religious/spiritual concepts. The potential for religious/spiritual appraisal to contribute to stigmatising or de-stigmatising infertility was discussed. Conclusion Our findings contradict the assumption that infertility physicians and patients are fully supportive of defining infertility as a disease. While potential benefits of the disease label were recognised by both groups, caution against potential for stigmatisation and unsolicited invocation of religion/spirituality suggest a more holistic model may be appropriate.

Involuntary Childlessness, Suffering, and Equality of Resources: An Argument for Expanding State-funded Fertility Treatment Provision.

Assessing what counts as infertility has practical implications: access to (state-funded) fertility treatment is usually premised on meeting the criteria that constitute the chosen definition of infertility. In this paper, I argue that we should adopt the expression "involuntary childlessness" to discuss the normative dimensions of people's inability to conceive. Once this conceptualization is adopted, it becomes clear that there exists a mismatch between those who experience involuntary childlessness and those that are currently able to access fertility treatment. My concern in this article is explaining why such a mismatch deserves attention and what reasons can be advanced to justify addressing it. My case rests on a three-part argument: that there are good reasons to address the suffering associated with involuntary childlessness; that people would decide to insure against it; and that involuntary childlessness is characterized by a prima facie exceptional kind of desire.

Clinical and Laboratory Characteristics of Infertile Women with Premature Ovarian Insufficiency

Background: Premature ovarian insufficiency (POI) is the preferred term for the condition that was previously referred to as premature menopause or premature ovarian failure. The condition differs from menopause in that there are varying and residual ovarian functions. This study aimed to analyze the clinical characteristics of infertile women with premature ovarian insufficiency. Material &amp; Methods: This prospective study was conducted at the OPD of Impulse Fertility Center, Impulse Hospital, Dhaka, Bangladesh. The study was conducted for a period from January 2022 to December 2022. A total of 23 patients who received outdoor treatment during the study period were purposively selected as sample size. A purposive sampling technique was followed in this study. After approval by the Ethics committee of the Hospital, informed consent from the respondents was obtained after explaining the purpose of the study to them. To be included in the study, respondents should have met the classical definition of infertility defined by the WHO as the inability of a sexually active non-contraceptive using woman to have a live birth after 12 or more months of regular sexual intercourse without a malefactor. Women who had male-factor infertility were excluded. In this study live birth was used as a measure of proven fertility (Because couples desire children, not simply pregnancies, infertility affects couples regardless of whether the etiology lies in conception or the progression of the pregnancy). All the necessary laboratory investigations were done. A questionnaire was developed and data were collected by interviewing the patients and some data were collected from the laboratory results. Data were processed and analyzed by SPSS 19 version. Results: All patients had normal puberty, and menarche occurred at ages 11–15, followed by a regular menstrual cycle. Women who presented with oligomenorrhea were younger than patients with infertility. The mean period of oligomenorrhea before diagnosis was 0.9 years in the oligomenorrhea group and 1.8 years in the infertility group. The mean age when the infrequent periods started was 28 years in the group with oligomenorrhea and 29 years in the group with infertility, and their anthropometric characteristics were not different. In most patients, the FSH levels on day 3 of their menstrual cycle were less than 25 mU/ml. FSH levels &gt;25 mU/ml were confirmed in two patients with oligomenorrhea and five patients in the infertility group. AMH levels were low than 1.0 ng/ml (considered to be in poor ovarian reserve ranges: from 0.13 to 1.0 ng/ml in patients with oligomenorrhea and from 0.13 to 0.9 ng/ml in the infertility group. Transvaginal ultrasound-determined AFC on menstrual cycle days 4–8 was accessed in all patients. We consider AFC &lt; 6 small follicles (diameters 3–9 mm) as a low ovarian reserve indicator. The lowest AFC (one small follicle) was noted in one infertile patient with oligomenorrhea. Conclusion: This study concluded that the subjects usually present with menstrual irregularity (oligomenorrhea) or infertility, and after proper evaluation, their poor ovarian reserve can be confirmed and an occult form of POI established. women who presented with only oligomenorrhea were younger than infertile patients; therefore, menstrual irregularity may be the earliest clinical symptom of occult POI.

ART and the forgotten siblings: a call for research.

A broader definition of infertility is the incapacity to have the intended number of children. However, most literature on ART exclusively focuses on live birth as an outcome, rather than on the capacity to fully realize the reproductive wishes of the couples. This issue has probably received scant attention because the total fertility rate is below replacement levels in affluent countries, and one may simplistically assume that only a minority of couples may be interested in more than one child. This assumption, however, is unproven and presumably erroneous. Unfortunately, evidence on the rate of return in couples who conceived their first child with ART is scant and information on the intended number of children in infertile couples is lacking. In general, we plea for more research on this subject. The documentation of an intended number of children above two and a high return rate in infertile couples may lead to changes in clinical practice, such as the storage of oocytes or embryos prior to initiating embryo transfers. This could improve the chance of conceiving the second child when the couple comes back some years later. In addition, the identification of the determinants for non-return as well as those explaining the gap between the intended and the realized number of children may reveal specific barriers and possibly how to tackle them. However, at present, available evidence is insufficient to advocate any intervention. Thorough research is warranted.

Public opinions regarding infertility treatment insurance coverage among marginalized patient populations.

To assess public support for insurance coverage of infertility treatment among marginalized patient groups. A cross-sectional, web survey-based study using a national sample of 1226 US adults. Participants responded to questions measuring their beliefs and attitudes towards support for infertility treatment insurance coverage among specific patient populations. We then evaluated the opinions of only the participants who supported infertility treatment insurance coverage for patients meeting the standard definition of infertility. Associations between demographic data of participants and support for infertility treatment insurance coverage among these marginalized groups were queried. Of the total responses, 61.9% of the respondents generally supported insurance coverage for infertility. Of the total responses, 54.5% did not support any insurance coverage for lesbian, gay, or transgender patients. Of those who generally supported the insurance coverage for infertility, 53.0% supported coverage for gay patients requiring infertility services, 54.6% supported coverage for lesbian patients, and 42.5% supported coverage for transgender patients. Of the total responses, 47.6% did not support insurance for green card holders, undocumented immigrants, or refugees. Of those who supported the insurance coverage for infertility in general, 63.6% supported insurance coverage for patients with green cards, 29.8% for refugees, and 20.7% for undocumented patients. For disability and genetic conditions, 39.5% did not support coverage for any groups. Of those who support the insurance coverage for infertility in general, there was most support for patients with physical disabilities (60.2%) followed by genetic disease (47.9%), then mental disabilities (31.4%). Even among those who support insurance coverage for infertility in general, approximately less than half of them supported these same treatments for marginalized groups, including the diverse sexuality and gender (DSG), immigrant, and disabled populations. Increased education and awareness of infertility is needed among the general population to garner acceptance of infertility as a disease and support insurance coverage of infertility treatment for all persons.

Association between co-exposure to phenols and phthalates mixture and infertility risk in women

BackgroundExposure to phenols and phthalates has been separately linked to increased risks of infertility in women of reproductive age. However, the combined effect of phenols and phthalates exposure on infertility has not been explored. MethodsData from the National Health and Nutrition Examination Surveys (NHANES) were used. A total of 857 women of reproductive age (18–45 years) with available information on urinary phenol and phthalate metabolites, reproductive questionnaires, and covariates were included in the present study. The definition of infertility was based on self-reports. Multivariable logistic regression, principal component analysis (PCA), and Bayesian kernel machine regression (BKMR) with stratified variable selection were applied to determine what associations were found between combined exposure to these mixtures and risk of infertility among women of reproductive age. ResultsAfter adjusting for potential confounders, bisphenol A (BPA), mono(3-carboxypropyl) phthalate (MCPP) and four di(2-ethylhexyl) phthalate (DEHP) metabolites [mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) and mono(2-ethyl-5-carboxypentyl) phthalate (MECPP)] were positively associated with infertility. PCA revealed that the DEHP-BPA factor's PC score was significantly positively related to the likelihood of infertility [adjusted odds ratio (aOR) = 1.45; 1.08, 1.82]. The DEHP-BPA component consistently had the highest group posterior inclusion probability (PIP) in BKMR models. The BKMR model also found that MEOHP, MEHHP, and BPA were positively associated with infertility risk when the remaining combination concentrations were held at their median values. In addition, we observed that the probability of infertility increased dramatically as the quantiles of total mixture concentration increased. ConclusionOur findings indicate that a combination of phenol and phthalate metabolites is linked to infertility among reproductive-age women. BPA and DEHP, in particular, are significantly related to the risk of infertility.

Evaluation of the fertility of patients after myomectomy in the department of Gynecology-Obstetrics of the Yalgado Ouedraogo University Hospital Center in Ouagadougou, Burkina Faso

Objective: To assess the fertility of patients after myomectomy in the Department of Gynecology-Obstetrics of the Yalgado Ouedraogo University Hospital Center from September 1, 2014 to August 31, 2018. Patients and methods: This were a retrospective cross-sectional descriptive and analytical exposure study with repeated survey and included patients of childbearing age who had undergone myomectomy during the study period; whose myomectomy is at least six (06) months old; having expressed a desire to become pregnant for at least twelve (12) months according to the definition of infertility; and having given their informed consent to the interview. Results: A total of 102 patients were included in our study. Infertility was primary in 64.71% and secondary in 35.29%. The mean age of the patients was 35.08 ± 5.42 years. Housewives accounted for 37.25%, and married women 66% of patients. After the myomectomy, 44 respondents (43.14%) achieved pregnancy; including 28/66 patients after primary infertility, and 16/36 after secondary infertility. The mean time to conception was 5.63 ± 3.46 months after the start of her postoperative quest. We observed 90.91% live births. Cesarean section was performed in 82.5% of patients and vaginal route in 17.5% of them. The main factors associated with fertility after myomectomy were: young age (p = 0.000), duration of infertility (p = 0.000), normal hysterosalpingography result (p = 0.000) and normal result spermogram of the spouse (p = 0.029). Conclusion: The relationship between myoma and infertility has not been clearly demonstrated. However, based on our results and given the difficulty of accessing ART, it seems lawful to us to offer myomectomy to patients with infertility associated with myomas, especially in patients under 35 years of age. A larger study would better establish the impact of myomectomy on the subsequent fertility of patients.

Physiological and Immunological Assessment in Infertile Women Undergoing In-vitro Fertilization

All the available reports on the issue of infertility confirmed the increase in this population problem worldwide. Although the accurate estimate of the number of infertile people is due to several reasons, including the discrepancy in the true definition of infertility (whether it extends for one, two or five years of failed pregnancy attempts), as well as the great discrepancy in the size of the selected population groups (large population sample size versus epidemiological studies) and defining the category that diagnosed included (individuals, women, or couples). The goal of today’s IVF program is to obtain high-quality embryos with high efficiency in development, which leads to an increase in live birth rates.

Глобальные социальные вызовы в проблемах бесплодия.

The problem of infertility remains a global problem of mankind according to WHO and today, infertility affects about 10–25% of couples of reproductive age worldwide, estimates vary from 48 to 186 million. When developing recommendations for the diagnosis and treatment of infertility in 2020, WHO did not revise the definition of infertility given in 2009, together with the International Monitoring Committee on Assisted Reproductive Technologies (ICMART) in the “Glossary of Definitions of Infertility and Treatment of Infertility”, where infertility is considered a disease reproductive system, defined as the inability to achieve clinical pregnancy after 12 months or more of regular unprotected intercourse. The same is the definition of male and female infertility in the International Classification of Diseases (ICD11). Higher rates of infertility are found in less developed countries/regions such as sub-Saharan Africa, South Asia, North Africa/Middle East, Central/Eastern Europe and Central Asia. At the same time, the researchers note that geographical differences in the level of infertility are associated with environmental, cultural and social factors. The etiology of infertility has different epidemiological characteristics depending on the region. Purpose: to review foreign scientific literature containing information on the prevalence of infertility in countries around the world, the role of social factors in its formation, and the availability of treatment assistance. Materials and methods: bibliographic, information-analytical methods and methods of comparative analysis. Results: in modern research in the field of studying the social factors of childlessness, special attention is paid to the description and clustering of groups of childless women. The global problem of infertility is associated with adverse physical and mental health outcomes, financial hardship, severe social stigma, increased risk of domestic violence, and marital instability. It has been shown that women with less than secondary education are less likely to seek help for infertility treatment than women with higher education. In high-income countries, immigrant women, uninsured women are less likely to have access to fertility treatment, and they are less informed about their rights, even if they seek treatment at a later age. Findings. Geographic differences in the prevalence of infertility in different countries are largely determined by social factors. The study of social factors of infertility in women showed that infertility is associated with a low quality of life. Although the likelihood of infertility in men and women is the same, and male infertility is responsible for more than half of all childlessness in the world, infertility remains primarily a social burden for women, especially in pronatalist societies. Women from wealthy backgrounds are more likely to have access to quality fertility treatment.

INFECTIONS ASSOCIATED WITH OBSTETRIC AND GYNECOLOGICAL SURGERIES AS A CAUSE OF FEMALE INFERTILITY IN UKRAINE.

The aim: To assess the role of surgical site infections types associated with obstetric and gynecological surgeries as a cause of infertility among women reproductive age in Ukraine. Materials and methods: We conducted a retrospective multicentre cohort study was based on reproductive health surveillance data among women reproductive age from 2019 to 2021. Definitions of infertility were used from the WHO and surgical site infections were used CDC/ NHSN. Results: Among all the 3,825 of infertility women in this study, the prevalence of surgical site infection (SSI) was 67.9%. The prevalence of SSI among primary infertility group and secondary infertility group women was 67.5% and 71.4%, respectively. There were differences among SSI type associated with infertility, primary infertility and secondary infertility. In logistic multivariate regression analyses, infertility was associated history of induced abortion (p < 0.001), history of obstetric and gynecological surgeries (p < 0.001), Salpingitis (p < 0.001), Oophoritis (p < 0.001), Endometritis (p < 0.001), Adnexa utery (p=0.009), and Pelvic abscess or cellulitis (p=0.043). The main factors associated with primary infertility were history of Salpingitis (33.6%) and Oophoritis (28.2%) after gynecological surgery. A factors associated with secondary infertility were history of Endometritis (27.2%), Pelvic abscess or cellulitis (11.2%), Salpingitis (10.1%), Adnexa utery (9.4%), Oophoritis (4.8%), and Chorioamnionitis (3.9%). Conclusions: One of the main causes of infertility in women of reproductive age in Ukraine are SSIs after obstetric and gynecological surgeries, and induced abortion. This applies to both primary and secondary infertility group women's in this cohort study.

PREVALENCE AND RISK FACTORS OF INFERTILITY IN UKRAINE: RESULTS A MULTICENTER STUDY (2019-2021).

The aim: To assess the current prevalence and identify the risk factors for infertility among couples of reproductive age in Ukraine. Materials and methods: We conducted a retrospective multicentre cohort study was based on reproductive health surveillance data among married populations from January 1st, 2019 to December 31st, 2021 in Ukraine. Definitions of infertility were used from the WHO. Results: Among all the 6,885 participants in this study, the prevalence of infertility was 25.4%. The prevalence of primary infertility was 5.8%, and the prevalence of secondary infertility was 19.6%. The levels of infertility in the regions of Ukraine had significant differences. It was found that among those women who had primary infertility, more were from rural than urban, while for secondary infertility women the situation was reversed. Infertility was associated with age, history of gynecological surgery, decreased ovarian reserve, age of marriage, long-term air-conditioning environment, and history of endometriosis. There were differences among factors associated with infertility, primary infertility and secondary infertility. The factors associated with primary infertility were age of marriage, age of first sexual intercourse, long-term air-conditioning environment, decreased ovarian reserve and age. A factors associated with secondary infertility were history of gynecological surgery and decreased ovarian reserve. Conclusions: The results of this study revealed high level the prevalence rate of infertility among couples of reproductive age in Ukraine is high. This applies to both primary and secondary infertility of married women. The most women who had experienced infertility have not sought medical or professional help for the problem.

Reproductive Ethics and Family

Reproductive Ethics and Family

Prevalence and Social Risk Factors of Infertility in Vietnam

Despite of significant social meaning of childlessness in Vietnam, there have been less scientific interests and social concerns about infertility during the past decades. This study aimed to measure infertility prevalence rate among Vietnamese married women and identifies the risk factors associated with vulnerability of infertility in social perspectives. A total of 11,715 married women aged between 20 and 44 years were selected from two rounds of Vietnam Multiple Indicator Cluster Survey in 2011 and 2014. The study applied a demographic definition of infertility; refers to an absence of live birth in the past 24 months among married women having desire of child and not using any contraceptive method. Primary infertility prevalence was decreased from 1.6% in 2011 to 1.1% in 2014, while secondary infertility increased from 3.5% to 3.7% during the same period. Multinomial logistic regression analysis revealed that age of women and husband, education, wealth index and age at first marriage were significantly associated with primary infertility, while education, wealth index and age at first marriage were significantly associated with secondary infertility. Despite some limitations, this study is helpful to understand infertility dynamics and some influencing factors increasing the risk of infertility in social context of the Vietnam.

Factors Affecting Infertility and Role of Growth Hormone in Management of Female Infertility: A Review

At our review we will discuss the definition of infertility according to the World Health Organization (WHO),types of infertility, factors determine fertility, factors affecting infertility in both men&amp;female as Body massindex (BMI), hormones and life style changes that are increasing in the current years and factors as (stressand smoking). Also discuss the role of Growth Hormone (GH) in management of women infertility.