A Meta-Analysis of The Prevalence and Etiology of Infertility in Iran

Infertility is a serious health issue in the world affecting approximately 8-10% of couples worldwide. The meta-analysisstudy was performed to assess the prevalence and etiologic factors associated with infertility in Iran. We made surethat the implementation of study and reporting the results were consistent with the MOOSE and PRISMA guidelines,respectively. All stages of the research were conducted by two authors, and the disagreement at each stage of the researchwas resolved by consensus. On January 1, 2020, we started a detailed literature search on international onlinedatabases, and Iranian Online databases, as well as specialized journals, several authentic international publishers andGoogle Scholar. We reviewed the reference list of identified articles for missed articles and then searched online forthem. Data analysis was performed to estimate the prevalence using a random effects model. The lifetime infertilityprevalence was found to be 11.3% [95% confidence interval (CI): 8.6-14.7] and the current infertility was evaluated tobe 3.7% (95% CI: 3.2-4.3). The prevalence of primary infertility (based on 45 articles consisting of 51,021 samples)as well as secondary infertility (based on 13 articles consisting of 35,683 samples) in Iran were estimated to be 18.3%(95% CI: 15.4-21.6) and 2.5% (95% CI: 1.6-4.0), respectively. The prevalence of female, male, both and unexplainedcauses was estimated to be 32.0% (95% CI: 27.6-36.8), 43.3% (95% CI: 38.2-48.6), 12.5% (95% CI: 9.6-16.2) and13.6% (95% CI: 10.2-17.8), respectively. The prevalence of causes related to ovulation, uterine tubes, and endometriosisin infertile women was estimated to be 54.0% (95% CI: 45.6-62.2), 15.5% (95% CI: 11.3-21.0), 6.2% (95%CI: 3.5-10.6), and 5.4% (95% CI: 2.5-11.3), respectively. In summary, the estimate of infertility burden in Iran didnot change between 1990 and 2017 and its prevalence remains high. This research presents a unified and up-to-dateoverview regarding the burden of infertility in Iran.