February 23, 2017

Despite its staggering impact, infertility in low-income countries is often a neglected and under-measured issue in reproductive health. Building on her previous research estimating infertility in the United States, Family Science Assistant Professor Marie Thoma and colleagues have applied a recently developed “current duration approach” for estimating couple infertility to nationally representative data from the 2013 Nigerian Demographic and Health Survey.

Using this approach, Thoma and colleagues determined time-to-pregnancy and 12-month infertility prevalence among couples based on reporting of approximately 7000 women ‘at risk’ of pregnancy at the time of interview.  Results indicated that the average time-to-pregnancy was 5.1 months, with approximately 31% of couples being infertile at the time of the interview.  The data was also examined for variations between primary and secondary infertility and  changes in time-to-pregnancy over 24 and 36 months.  Variations were noted over time and across differences in age, coital frequency, and fertility intentions. The authors note that this approach has been previously assessed in the U.S. and Europe, but this is the first application of a current duration in a low-income setting. The measure offers a pragmatic, cost-effective means for generating country-level infertility prevalence estimates from existing cross-sectional studies and could be used to highlight the magnitude of this issue and facilitate response planning.  Dr. Thoma and her colleagues note that improved infertility data can have enormous impact for families in such settings, particularly related to marital instability and stigma for women.  While men and women are equally likely to be infertile, women are often blamed for a couple’s childlessness. Meanwhile, accurate infertility estimates can help shape policy and social views on women's health and family planning programs and services. 

Dr. Thoma notes that in her research, she “strives to provide population-based methods that can be used widely to improve reproductive and maternal/child health programs, particularly among underserved populations. This new research, in collaboration with colleagues from the Guttmacher Institute, the World Health Organization, and academia, provides a potential opportunity for accelerated measurement of infertility globally, particularly in regions where women may suffer the most severe consequences of infertility.” 

Estimating infertility prevalence in low-to-middle-income countries: An application of a current duration approach to demographic and health survey data is published in Human Reproduction, and was co-authored with Drs. Chelsea B. Polis, Carie M. Cox, Özge Tunçalp, and Alexander C. McLain.  Through funding by the World Health Organization, the article is available to the public as an OpenAccess publication. 

 

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