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-analysis study was performed to assess the prevalence and etiologic factors associated with infertility in Iran. We made sure that 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 research was resolved by consensus. On January 1, 2020, we started a detailed literature search on international online databases, and Iranian Online databases, as well as specialized journals, several authentic international publishers and Google Scholar. We reviewed the reference list of identified articles for missed articles and then searched online for them. Data analysis was performed to estimate the prevalence using a random effects model. The lifetime infertility prevalence was found to be 11.3% [95% confidence interval (CI): 8.6-14.7] and the current infertility was evaluated to be 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 unexplained causes 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) and 13.6% (95% CI: 10.2-17.8), respectively. The prevalence of causes related to ovulation, uterine tubes, and endometriosis in 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 did not change between 1990 and 2017 and its prevalence remains high. This research presents a unified and up-to-date overview regarding the burden of infertility in Iran.