Risk factors for secondary infertility among women attending infertility clinic at Kawempe National Referral Hospital: A matched case-control study

Abstract

Background: Infertility has emerged as one of global public health issues with approximately 8- 15% of couples affected globally. In Africa secondary infertility is more common than primary infertility and is largely due to preventable or treatable causes such as STIs, and abortions. General Objective: To determine the risk factors for secondary infertility among women attending infertility clinic at Kawempe National Referral Hospital. Methods: This was an age-group matched case control study conducted among 57 cases (with at least one previous pregnancy and failure to become pregnant for up to 12 months or more of engaging in unprotected coitus regularly) and 114 controls (pregnant women with at least one previous pregnancy) attending the Antenatal clinic at Kawempe National Referral Hospital). Cases were sampled consecutively from the infertility clinic while the controls in similar age groups were sampled consecutively from ANC. Data was collected using a structured questionnaire. Data analysis was carried out using STATA version 16. The risk factors for secondary infertility were obtained using binary logistic regression multivariable analysis. Results: The significant risk factors for secondary infertility found in this study were change of partner, history of abortions and PID. Association of secondary infertility with history of abortions with (AOR= 2.73, CI: 1.36-5.46) (p=0.005), PID with (AOR=3.24, CI: 1.59-6.58) (p=0.001) and change of partner with (AOR =2.42, CI: 1.00-5.85) (p=0.049). Unemployment was however found to be a protective factor for secondary infertility with (AOR=0.38, CI: 0.16-0.86) (p=0.021) Conclusion: PID, abortions and change of partner are risk factors for secondary infertility whereas unemployment may be a protective factor.