Socio-demographic Determinants of Infertility: A Study in Four Selected Provinces of Iran

Objectives: Infertility is one of the reproductive health issues that not only affects infertile couple's life, but it is a matter of demographic concerns on a vast scale. This study aims to examine the impact of socio-demographic factors on the incidence of infertility. Materials and Methods: TWe used data from our cross-sectional fertility survey conducted in 2017 in four selected provinces of Iran including Gilan, West Azarbaijan, Sistan and Baluchistan, and Yazd. Using a structured questionnaire, 4088 women of reproductive age were interviewed in the survey for their reproductive life history as well as their socio-demographic and economic condition. Bivariate (chi-square test), and multivariate (Multiple Logistic Regression) analyses are applied to the data to meet the aim of the study. P values less than 0.05 are considered statistically significant where differentials are tested. Results: The prevalence of current infertility according to clinical definition varied from 7.4% in Yazd, 8.6% in West Azerbaijan, 12.4% in Gilan, and 22.3% in Sistan and Baluchistan. Logistic regression analysis revealed a significant association between infertility and the age and age at marriage of women. Controlling for other socio-demographic variables probability of being infertile increases as women get married at an older age. In addition, women who lived in a household with the lowest socio-economic conditions were 80 percent more likely to experience infertility compared to those living in households with the highest socio-economic conditions. Living in Sistan and Baluchistan was also a strong predictor of infertility in the study resulting in a high odds ratio (3.050) compared with women living in Yazd province Conclusions: Women's age and age at marriage are the most important demographic characteristics in explaining infertility and having a lower socio-economic condition may trigger it. Similarly, living in Sistan and Baluchistan itself explains a lot of differentials when women are compared with their counterparts in other provinces. Since the age of marriage is increasing in Iran, it may affect primary infertility where childbearing is postponed to the late 30s and early 40s.