The Prevalence of Infertility and Factors Associated with Infertility in Ethiopia: Analysis of Ethiopian Demographic and Health Survey (EDHS)

Background: Despite having a high fertility rate, low-resource countries are also home to couples with infertility problems. Although many couples are suffering from the psychological impacts of infertility, its level and determinants are not adequately known. The main objective of this study is to assess the prevalence and factors associated with infertility among couples in Ethiopia using the 2016 Ethiopian Demographic and Health Survey (EDHS) data.

Method: The study employed a cross-sectional study design extracting variables from the 2016 EDHS. The study included all married or cohabitating women aged 15 to 49 years in the Couples Recode (CR) file data set. Weighted samples of 6141 respondents were analyzed. We used Stata 14 software for analyzing the data. The association of selected independent variables with primary, secondary, and total infertility was analyzed using a logistic regression model. We presented the results using an adjusted odds ratio (AOR) with a 95% confidence interval (CI) and a p-value <0.05 as a cut-off point for declaring statistical significance.

Results: The prevalence of infertility in the past 12 months was 24.2% (95% CI: 23.1-25.3%), of which the majority (90.7%) was secondary infertility. Greater than 35 years of age (AOR = 2.45, 95% CI (1.58-3.79)), rural residence (AOR = 1.06, 95% CI (1.01-1.39)), smoking (AOR = 2.29, 95% CI (1.39-3.77)), and <18.5 Body Mass Index (BMI) (AOR = 1.71, 95% CI (1.43-2.04)) were significantly associated with infertility. Conversely, infertility was less likely among women with formal education and better wealth index. Primary infertility was significantly higher among women whose partners drink alcohol (AOR = 1.55; 95% CI 1.06-2.28)) and chew khat (AOR = 1.62; 95% CI (1.12-2.36)). Secondary infertility was significantly higher among women with <18.5 BMI (AOR = 1.59, 95% CI (1.37-1.84)), >30 BMI (AOR = 1.54; 95% CI 1.01-2.35)), and <15 years of age at first birth (AOR = 1.40; 95% CI 1.15-1.69)).

Conclusion: More than one in five couples in Ethiopia has an infertility problem. Both male and female-related factors are associated with infertility. Primary infertility was significantly higher among women whose partner chews khat and drinks alcohol. Secondary infertility was significantly associated with being underweight, obese, smoking, and young age at first birth. Hence, taking action on preventable factors is the most critical treatment approach and will improve the health status of the couples in other ways.