Prevalence of infertility and the effect of covariates on survival time to pregnancy: A nationally representative population based cross sectional study.

Objective: This study sought to estimate population level prevalence of infertility and explored whether time to pregnancy is related to selected factors.

Methods: This study's analysis was based on data collected from 2081 women who were sampled from participants of the 2016 Ethiopia Demographic and Health Survey based on risk of pregnancy criteria: age between 15 and 49 years, currently married or cohabitating, sexually active, not used contraception method during the 5 years before interview, not menopausal, and not pregnant. We used a current duration (CD) approach in which for each woman we calculated the length of time-at-risk of pregnancy (CD value) in months. A parametric survival model was fitted to CD values from which the median time to pregnancy (TTP) and prevalence of infertility were estimated. To explore variables associated with a longer TTP accelerated failure time, regression models were built to estimate time ratios.

Results: The median TTP was 4 months (95% confidence interval [CI] 3.9-4.1). The 12-month prevalence of overall, primary, and secondary infertility were 29.5% (95% CI 27.50-31.47), 31.1% (95% CI 27.85-34.48), and 27.7% (95% CI 25.30-30.23), respectively. A longer TTP was observed for women aged 35 to 49 (P = 0.001), nulliparous (P = 0.00), when the usual residence of the husband is outside the home (P = 0.001), for women who want to give birth soon (P = 0.00), for cigarette smokers (P = 0.027), for rich women (P = 0.002), and for tertiary (P = 0.00) and primary educated women (P = 0.00).

Conclusion: This study suggests reproductive-age women, which indicates that large numbers of Ethiopian women need fertility services.