Volume 2021, Issue 3

Abstract

Background/aim: Infertility is defined as the inability of heterosexual couples to achieve a successful clinically recognizable pregnancy after 12 months or more of regular, unprotected sexual intercourse. Infertility estimations are very important to inform the healthcare policymakers and governments to implement appropriate social and economic policies. Thus, this study aimed to estimate the pooled prevalence of infertility (primary and secondary) and its etiologic factors in Sudan.

Methods: This study included all published and unpublished studies written in Arabic or English. Electronic sources (namely, PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov) and nonelectronic sources (direct Google search, Google Scholar, OpenGrey, OATD, WorldCat log, and university websites) were used from their inception to May 16, 2021. A total of 1955 studies were reviewed, of which only 20 studies were eligible for the meta-analysis. Studies were eligible if they provided the prevalence of infertility in Sudan. The Joanna Briggs Institute Quality Assessment Tool was used to evaluate each study. Data synthesis and statistical analysis were conducted using Jeffrey's Amazing Statistics Program version 0.14.1.0.

Results: The pooled prevalence of overall infertility, primary infertility, and secondary infertility in Sudan were 13% (I2 = 96.45,  < 0.001), 65% (I2 = 98.5,  < 0.001), and 35% (I2 = 98.5,  < 0.001), respectively, and the prevalence of infertility factors were 41%, 27%, 16%, and 17% for female, male, combined factors, and unexplained factors, respectively. Women with infertility were mainly present because of ovulatory disorders (ovulatory factors, 36%; polycystic ovary syndrome, 38%). By contrast, spermatic disorders such as azoospermia (37%), oligozoospermia (30%), and asthenozoospermia (30%) were the main causes of male infertility.

Conclusion: In Sudan, the prevalence of primary infertility is higher than that of secondary infertility. Female factors were the most common causes of infertility in Sudan, and this study found a high prevalence of unexplained factors. Polycystic ovary syndrome and azoospermia were the most common causes of female and male infertility in Sudan, respectively. The interpretation of these findings should take into consideration the presence of substantial heterogeneity between the included studies.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2021.47
2021-10-01
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2021/3/qmj.2021.47.html?itemId=/content/journals/10.5339/qmj.2021.47&mimeType=html&fmt=ahah

References

  1. World Health Organizationa. Infertility definitions and terminology [World Health Organization global, Geneva, Switzerland, 4 February 2020]4. [cited 2021 May 17]. Available from: https://www.who.int/news-room/fact-sheets/detail/infertility .
    [Google Scholar]
  2. HS, Pal L, Sell E. Speroff's clinical gynecologic endocrinology and infertility: Lippincott Williams & Wilkins; 2019.
    [Google Scholar]
  3. World Health Organizationb. Infertility [World Health Organization global, Geneva, Switzerland, 14 September 2020]. [cited 2021 May 17]. Available from: https://www.who.int/reproductivehealth/topics/infertility/keyissues/en/.
  4. Yasin, Nagat Sidig; Elnimeiri, Mustafa Khidir. Causes of infertility among Sudanese women in Khartoum State Sudan 2013. IOSR Journal of Nursing and Health Science, NHS, 2013: 6, (3):28–31. https://doi.org/10.9790/1959-0603XXXXX .
    [Google Scholar]
  5. Petraglia, Felice; Serour, Gamal I.; Chapron, Charles. The changing prevalence of infertility. Int J Gynaecol Obstet, 2013, 123: (2):S4–S8. https://doi.org/10.1016/j.ijgo.2013.09.005 .
    [Google Scholar]
  6. Manders M, McLindon L, Schulze B, Beckmann MM, Kremer JA, Farquhar C. Timed intercourse for couples trying to conceive. Cochrane Database Syst Rev. 2015(3):CD011345. https://doi.org/10.1002/14651858.CD011345.pub2 .
    [Google Scholar]
  7. Sun, Hui; Ting-Ting, Gong; Yu-Ting, Jiang; Shuang, Zhang; Yu-Hong, Zhao; Qi-Jun, Wu. Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990–2017: results from a global burden of disease study, 2017. Aging (Albany NY), 2019, 11: (23):10952–10991.
    [Google Scholar]
  8. Eze, Ukpai Agwu; Okonofua, Friday E. High prevalence of male infertility in Africa: are mycotoxins to blame? Afr J Reprod Health, 2015, 19:(3):9-17.
    [Google Scholar]
  9. Abebe, Melese Shenkut; Afework, Mekbeb; Abaynew, Yeshiwas. Primary and secondary infertility in Africa: systematic review with meta-analysis. Fertil Res Pract, 2020, 6:(1):1–11. https://doi.org/10.1186/s40738-020-00090-3 .
    [Google Scholar]
  10. Khalifa DA, Mohamed Awad. Reviewing infertility care in Sudan; socio-cultural, policy and ethical barriers. Facts, Views & Vision in ObGyn. 2012; MOnOGraph:53–58.
    [Google Scholar]
  11. Elhussein, Osama G; Mohamed, Ahmed A; Suliman, Suliman O; Ishag, Adam. Epidemiology of infertility and characteristics of infertile couples requesting assisted reproduction in a low-resource setting in Africa, Sudan. Fertil Res Pract, 2019, 5:(1):1–5. https://doi.org/10.1186/s40738-019-0060-1 .
    [Google Scholar]
  12. Elussein, Elsir A, Yagoub, Magid M; Maha, Omer M; Ishag, Adam. Clinical patterns and major causes of infertility among Sudanese couples. Trop Doct, 2008, 38:(4):243–244. https://doi.org/10.1258%2Ftd.2007.070125 .
    [Google Scholar]
  13. Omer HMH, Khalid KE, Miskeen EI, Taha MY, Saleh EY, Ahmed EA, et al. Cytological and molecular screening of Chlamydia trachomatis in infertile women attending a maternity teaching hospital in Gezira State, Sudan: a cross-sectional study. F1000 Research. 2020; 9:(589):589–602. https://doi.org/10.12688/f1000research.23490.1 .
    [Google Scholar]
  14. Ahmed, Mohamed; Osama, Shareef; Ishag, Adam; Duria, Rayis. Maternal age and intracytoplasmic sperm injection outcome in infertile couples at Khartoum, Sudan. F1000 Research, 2015910, 2015, 4:1339–1350. https://dx.doi.org/10.12688%2Ff1000research.7386.1 .
    [Google Scholar]
  15. Hussein M, Gafoor M, Gadir A, Hamad M. Prevalence of primary infertility among selected group of Sudanese women with infertility disorders. MOJ Women's Health. 2019; 8:(1):107–108. https://doi.org/10.15406/mojwh.2019.08.00221 .
    [Google Scholar]
  16. Ericksen, Karen; Brunette, Tracy. Patterns and predictors of infertility among African women: a cross-national survey of twenty-seven nations. Soc Sci Med, 1996, 42:(2):209–220. https://doi.org/10.1016/0277-9536(95)00087-9 .
    [Google Scholar]
  17. Larsen, Ulla. Primary and secondary infertility in sub-Saharan Africa. Int J Epidemiol. 2000, 29:(2):285–291. https://doi.org/10.1093/ije/29.2.285 .
    [Google Scholar]
  18. Abdalla, Nezar M. Pattern of infertility among couples in Gezira Area, Sudan. Med J Cairo Univ. 2011, 79:(2):529–532.
    [Google Scholar]
  19. Abdalla, NM. Epidemiology of infertility in Gezira region, central of Sudan. Research Journal of Medical Sciences. 2011, 5:(1):56–60.
    [Google Scholar]
  20. Abdallah, H.E.A.A.M. Study of Female Infertility in Sudanese using Ultrasonography. PhD, Sudan University of Science and Technology, Sudan, 2019.
    [Google Scholar]
  21. Ahmed M, Mansour MM, Khalid KE, Yosif N, Elhasan EM, Miskeen E. Semen analysis of infertile Sudanese males in Gezira state central Sudan. Sudanese Journal of Public Health. 2009; 4:(3):340–344.
    [Google Scholar]
  22. Abdel Rahman, M.M.A. Pattern of infertility among Sudanese couples attending at police university hospital, PhD, university of Khartoum, Sudan, 2003.
    [Google Scholar]
  23. Abdelrahman, H.E.A. Diagnostic Ultrasonic Assessment of in Vitro Fertilization in Women in the period July 2010 to March 2011. PhD, University of science and technology, Sudan, 2011.
  24. Albalola, A.A.A. Study of Female Infertility using Ultrasonography. MSc, Sudan University of Science and Technology, Sudan, 2018.
  25. Abbas, E.G.H. Effect of Age on Success Rate of IVF Treatment among Infertile Sudanese women In Khartoum state. MSc, Sudan University of Science & Technology, Sudan, 2017.
  26. Husain, N.M. K.M. A Study of Female Infertility using Ultrasonography. MSc. Sudan University of Science and Technology, Sudan, 2017.
  27. Geaballah. M.G.A. Couples Knowledge and attitude regarding Infertility in Khartoum Fertility Centers, MSc, National Ribat University, Sudan, 2017.
  28. Nabag W.O.M., Omer MI, Farajalla EA, Nour A, Ellaithy S, Sheikh MAAE. Correlation of Aspirated Peritoneal Fluid Findings at Laparoscopy and Tubal Pathology in Infertile Women. Australian Journal of Basic and Applied Sciences. 2011; 5:(8):1449–1455.
    [Google Scholar]
  29. Elsheikh M.A., Gerais AM, Rogia A. Prevalence of female infertility in four regions in the Sudan. Eur J Obstet Gynaecol 2002.1617.
    [Google Scholar]
  30. Joanna Briggs Institute Quality Assessment Tool. Critical Appraisal tools for use in JBI Systematic Reviews [Internet]. [cited 2021 May 17]. Available from: https://jbi.global/critical-appraisal-tools .
    [Google Scholar]
  31. Higgins, Julian PT; Simon, Thompson G; Jonathan, Deeks J; Douglas, Altman G. Measuring inconsistency in meta-analyses. BMJ. 2003, 327:(7414):557–560. doi: https://doi.org/10.1136/bmj.327.7414.557 .
    [Google Scholar]
  32. United Nations. Sustainable Development [United Nations Organization Department of Economic and Social Affair, New York, USA, 1 January 2016]. [cited 2021 July 28]. Available from: https://sdgs.un.org/goals .
  33. Naz, Marzieh Saei Ghare; Ozgoli, Giti; Sayehmiri, Koroush. Prevalence of infertility in Iran: a systematic review and meta-analysis. Urol J. 2020, 17:(4):338–345. https://doi.org/10.22037/uj.v0i0.5610 .
    [Google Scholar]
  34. Mohamed Elawad NA. Situation of sexually transmitted infections (STIs) in Sudan. Obstet Gynecol Int J, 2018, 9:(6):503–505. doi: 10.29011/ARRHI-102.100002 .
    [Google Scholar]
  35. Badawi, M. M.; Atif, M. S.; Mustafa, Y.Y. Systematic review and meta-analysis of HIV, HBV and HCV infection prevalence in Sudan. Virology J, 2018, 15:(1):1–16. https://doi.org/10.1186/s12985-018-1060-1 .
    [Google Scholar]
  36. Eldib, Abdallah; Osama, Tashani A. Infertility in the Middle East and North Africa Region: a systematic review with meta-analysis of prevalence surveys. Libyan J Med. 2018, 2:(2):37. DOI: 10.4103/LJMS.LJMS_24_18 .
    [Google Scholar]
  37. Ryu, Youngjae; Sung, Woo Kim, Yoon, Young Kim, Seung-Yup, Ku. Animal models for human polycystic ovary syndrome (PCOS) focused on the use of indirect hormonal perturbations: a review of the literature. Int J Mol Sci. 2019, 20:(11):2720. https://doi.org/10.3390/ijms20112720 .
    [Google Scholar]
  38. Lim, Siew S.; Samantha, Hutchison K; Emer, Van Ryswyk; Robert, Norman J; Helena, Teede J; Lisa, Moran J. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2019, (3):1–90. Art. No.: CD007506. https://doi.org/10.1002/14651858.CD007506.pub4 .
    [Google Scholar]
  39. Kiani, Zahra; Masoumeh, Simbar; Sepideh, Hajian; Farid, Zayeri; Maryam, Shahidi; Marzieh, Saei Ghare Naz, et al. The prevalence of anxiety symptoms in infertile women: a systematic review and meta-analysis. Fertil Res Pract. 2020, 6:(1):1–10. https://doi.org/10.1186/s40738-020-00076-1 .
    [Google Scholar]
  40. World bank. Physicians (per 1,000 people) Sudan [World bank organization, Washington DC, USA, 30 July 2017]. [cited 2021 May 17]. Available from: https://data.worldbank.org/indicator/SH.MED.PHYS.ZS?locations = SD&name_desc = false .
  41. Worldometers. Sudan Population [Worldometer company, USA, 1 July 2020]. [cited 2021 May 17]. Available from: https://www.worldometers.info/world-population/sudan-population/.
  42. World Health Organisation, et al. Global reference list of 100 core health indicators. World Health Organization, 2015.
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2021.47
Loading
/content/journals/10.5339/qmj.2021.47
Loading

Data & Media loading...

Keyword(s): meta-analysisprevalenceprimary infertilitysecondary infertilitySudan and unexplained infertility

Most Cited Most Cited RSS feed