Prevalence of Primary and Secondary Infertility in Zahedan, Southeast Iran, 2020-2022: A Cross-Sectional Population-based Study.

Background: Worldwide, infertility is the third most serious illness of the 21^st century, after cancer and cardiovascular diseases. This study aims to evaluate the prevalence and epidemiology of female infertility in the city of Zahedan, Southeast Iran.

Materials and methods: This cross-sectional population-based study was conducted from 2020 to 2022 on all female Iranian residents of Zahedan. The women, aged 15-45 years, had been married for at least one year and reported no contraceptive use for at least 12 months from the onset of their marriage until the time of the study. We used a multi-stage sampling method to conduct face-to-face interviews with the 440 eligible women. Data were analysed using the chi-square test, t test, and logistic regression model. P<0.05 were considered statistically significant.

Results: The mean age of the women was 30.45 ± 9.44 years and 71.1% were urban residents. There were 14.5% of women who were infertile (4.8%: primary; 9.8%: secondary). The most prevalent infertility occurred in women who were 26 to 30 years of age. Age group and infertility did not show a significant correlation (P=0.05). The results indicated that 12.8 and 18.9% of urban and rural residents were infertile, respectively. Rural residents reported primary infertility more than urban residents (10.2 vs. 2.6%, P=0.005). On average, the time from decision to become pregnant to pregnancy lasted 7.97 ± 9.15 months for fertile women and 42.81 ± 42.36 months for infertile women (P<0.001). Female factor (70.3%) and male factor (14.1%) were the most common reasons for infertility.

Conclusion: This study, performed for the first time in Zahedan, Sistan and Baluchistan province showed a high prevalence of infertility. Given the growing concern about the aging population in Iran, the findings of this study could be informative and beneficial for regional health policymakers and providers. More studies on infertility and its causes in might help policymakers to make appropriate interventions to increase the fertility rate.