Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-23T09:15:00.811Z Has data issue: false hasContentIssue false
  • English
  • Français

PREVALENCE AND RISK FACTORS OF INFERTILITY IN TURKEY: EVIDENCE FROM DEMOGRAPHIC AND HEALTH SURVEYS, 1993–2013

Published online by Cambridge University Press:  23 June 2017

Melike Sarac  and
Ismet Koc
Melike Sarac*
Affiliation:
Institute of Population Studies, Hacettepe University, Ankara, Turkey
Ismet Koc
Affiliation:
Institute of Population Studies, Hacettepe University, Ankara, Turkey
*
1Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Summary

The inability to have children affects couples worldwide and causes emotional and psychological distress in both men and women. Turkey is a country that lays particular emphasis on the issue of infertility, especially after experiencing a dramatic fertility decline over the last two decades. This study aimed to understand the changes in the prevalence of infertility in Turkey using three different approaches: the DHS Approach, the Constructed Approach and the Current Duration Approach. Furthermore, the factors contributing to elevated risks of infertility as derived from the Constructed Approach were investigated using four different logistic regression models. The data came from the 1993, 1998, 2003, 2008 and 2013 Demographic and Health Surveys conducted by the Hacettepe University Institute of Population Studies. The findings of the Constructed and Current Duration Approaches suggested that the prevalence of infertility decreased markedly from 1993 to 2013 in Turkey. This decline was the result of improvements in maternal health care services in Turkey, as well as an increase in the use of Assisted Reproductive Technology (ART), from 1.9% in 2008 to 4.1% in 2013. The results of the final logistic regression model suggested that the risk of infertility was significantly higher among women aged between 35 and 49 (p<0.01), uneducated women (p<0.01), women whose age at first marriage was over 30 (p<0.01), women defined as overweight (p<0.05) and women whose age at menarche was less than 12 years (p<0.05). This is the first nationwide study to examine the prevalence of infertility and its socio-demographic risk factors in Turkey, a developing country; previous studies have established these risk factors mainly in developed countries.

Type
Research Article
Information
Journal of Biosocial Science , Volume 50 , Issue 4 , July 2018 , pp. 472 - 490
Copyright
Copyright © Cambridge University Press, 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adamson, P. C., Krupp, K., Freeman, A. H., Klausner, J. D., Reingold, A. L. & Madhivanan, P. (2011) Prevalence and correlates of primary infertility among young women in Mysore India. Indian Journal of Medical Research 134, 440–446.Google Scholar
Anderson, K., Nisenblat, V. & Norman, R. (2010) Lifestyle factors in people seeking infertility treatment – a review. Australian and New Zealand Journal of Obstetrics and Gynaecology 50, 8–20.CrossRefGoogle ScholarPubMed
Bhattacharya, S., Porter, M., Amalraj, E., Templeton, A., Hamilton, M., Lee, A. J. & Kurinczuk, J. J. (2009) The epidemiology of infertility in the North East of Scotland. Human Reproduction 24, 3096–3107.Google Scholar
Blenner, J. L. (1990) Passage through infertility treatment: a stage theory. Journal of Nursing Scholarship 22, 153–158.CrossRefGoogle ScholarPubMed
Bliss, C. (1999) The social construction of infertility by minority women. Doctoral dissertation, Denver University.Google Scholar
Boivin, J., Bunting, L., Collins, J. A. & Nygren, K. G. (2007) International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Human Reproduction 22, 1506–1512.CrossRefGoogle ScholarPubMed
Bos, H., van Balen, F. & Visser, A. (2005) Social and cultural factors in infertility and childlessness. Patient Education and Counseling 59, 223–225.Google Scholar
Brassard, M., AinMelk, Y. & Baillargeon, J. P. (2008) Basic infertility including polycystic ovary syndrome. Medical Clinics of North America 92, 1163–1192.CrossRefGoogle ScholarPubMed
Bushnik, T., Cook, J. L., Yuzpe, A. A., Tough, S. & Collins, J. (2012) Estimating the prevalence of infertility in Canada. Human Reproduction 27, 738–746.Google Scholar
Chen, J., Zhong, C., Liang, H., Yang, Y., Zhang, O., Gao, E. & Miao, M. (2015) The relationship between age at menarche and infertility among Chinese rural women. European Journal of Obstetrics & Gynecology and Reproductive Biology 194, 68–72.Google Scholar
Chowdhury, M. A., Haque, M. M., Chowdhury, S. & Prodhania, M. S. (2014) Determinants of infertility among couples seeking treatment in a selected clinic in Dhaka city. Chattagram Maa-O-Shishu Hospital Medical College Journal 13, 42–45.Google Scholar
Cox, C. M., Polis, C. B., Tuncalp, O., McLain, A. C. & Thoma, M. E. (2016) Estimating the prevalence of infertility in Nigeria: application of a current duration methodological approach to Demographic and Health Survey data. Presented at the Population Association of America Conference, March/April 2016, Washington, DC.Google Scholar
Delpisheh, A., Brabin, L. & Brabin, B. J. (2006) Pregnancy, smoking and birth outcomes. Women’s Health 2, 389–403.Google Scholar
Dhont, N., Luchters, S., Muvunyi, C., Vyankandondera, J., De Naeyer, L., Temmerman, M. & van de Wijgert, J. (2011) The risk factor profile of women with secondary infertility: an unmatched case-control study in Kigali, Rwanda. Women’s Health 11, 32–38.Google Scholar
Direkvand-Moghadam, A., Delpisheh, A., Direkvand-Moghadam, A., Karzani, P., Saraee, P., Safaripour, Z. & Mir-Moghadam, N. (2015) Predictive factors for infertility of women: an univariate and multivariate logistic regression analysis. International Journal of Epidemiologic Research 2, 4–11.Google Scholar
Esmaeilzadeh, S., Delavar, M. A., Zeinalzadeh, M. & Mir, M. R. A. (2012) Epidemiology of infertility: a population-based study in Babol, Iran. Women & Health 52, 744–754.Google Scholar
Gerrits, T. (1997) Social and cultural aspects of infertility in Mozambique. Patient Education and Counseling 31, 39–48.CrossRefGoogle ScholarPubMed
Gerrity, D. A. (2001) A biopsychosocial theory of infertility. The Family Journal 9, 151–158.CrossRefGoogle Scholar
Gokler, M. E., Unsal, A. & Arslantas, D. (2014) The prevalence of infertility and loneliness among women aged 18–49 years who are living in semi-rural areas in Western Turkey. International Journal of Fertility & Sterility 8, 155–162.Google Scholar
Goldman, M. B., Missmer, S. A. & Barbieri, R. L. (2000) Infertility. In Goldman, M. B. & Missmer, S. A. (eds) Women and Health. Academic Press, San Diego, pp. 196–214.CrossRefGoogle Scholar
Gougeon, A. (2005) The biological aspects of risks of infertility due to age: the female side. Revue d’Epidemiologie et de Santé Publique 53, 2S37–2S45.Google ScholarPubMed
Greil, A. L. & McQuillan, J. (2004) Help‐seeking patterns among subfecund women. Journal of Reproductive and Infant Psychology 22, 305–319.Google Scholar
Greil, A., McQuillan, J. & Slauson‐Blevins, K. (2011) The social construction of infertility. Social Compass 5, 736–746.CrossRefGoogle Scholar
Greil, A. L., Slauson‐Blevins, K. & McQuillan, J. (2010) The experience of infertility: a review of recent literature. Sociology of Health & Illness 32, 140–162.CrossRefGoogle ScholarPubMed
Grodstein, F., Goldman, M. B. & Cramer, D. W. (1994) Body mass index and ovulatory infertility. Epidemiology 5, 247–250.Google Scholar
Gurtin, Z. B. (2011) Banning reproductive travel: Turkey’s ART legislation and third-party assisted reproduction. Reproductive Biomedicine Online 23, 555–564.CrossRefGoogle ScholarPubMed
HUIPS (2004) 2003 Turkey Demographic and Health Survey, 1st Edition. Hacettepe University Institute of Population Studies and Turkey Ministry of Health, Ankara, Turkey.Google Scholar
Inhorn, M. C. (1996) Infertility and Patriarchy: The Cultural Politics of Gender and Family Life in Egypt. University of Pennsylvania Press, PA, USA.Google Scholar
Inhorn, M. C. & Gurtin, Z. B. (2012) Infertility and assisted reproduction in the Muslim middle east: social, religious, and resource considerations. Facts Views & Visions in ObGyn, Monograph, 24–29.Google Scholar
Kelly-Weeder, S. & Cox, C. L. (2006) The impact of lifestyle risk factors on female infertility. Women Health 44, 1–23.Google Scholar
Komura, H., Miyake, A., Chen, C. F., Tanizawa, O. & Yoshikawa, H. (1992) Relationship of age at menarche and subsequent fertility. European Journal of Obstetrics & Gynecology and Reproductive Biology 44, 201–203.Google Scholar
Leonard, L. (2002) Problematizing fertility. In Inhorn, M. C. & Van Balen, F. (eds) Infertility Around the Globe: New Thinking on Childlessness, Gender, and Reproductive Technologies. University of California Press, London, pp. 119–133.Google Scholar
Marchbanks, P. A., Peterson, H. B., Rubin, G. L. & Wingo, P. A. (1989) Research on infertility: definition makes a difference, The Cancer and Steroid Hormone Study Group. American Journal of Epidemiology 130, 259–267.Google Scholar
Mascarenhas, M. N., Flaxman, S. R., Boerma, T., Vanderpoel, S. & Stevens, G. A. (2012) National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PloS Medicine 9, e1001356.Google Scholar
Pasch, L. A. & Dunkel-Schetter, C. (1997) Fertility problems: complex issues faced by women and couples. In Gallant, K. et al. (ed.) Health Care for Women: Psychological, Social, and Behavioral Influences. American Psychological Association, Washington, DC, pp. 187–201.CrossRefGoogle Scholar
Pasquali, R., Patton, L. & Gambineri, A. (2007) Obesity and infertility. Current Opinion in Endocrinology, Diabetes and Obesity 14, 482–487.Google Scholar
Pennings, G., de Wert, G., Shenfield, F., Cohen, J., Tarlatzis, B. & Devroey, B. (2009) Providing infertility treatment in resource-poor countries. Human Reproduction 24, 1008–1011.Google Scholar
Romero, R. R., Romero, G. G., Abortes, M. I. & Medina, S. H. (2008) Risk factors associated to female infertility. Ginecologia y Obstetricia de Mexico 76, 717–721.Google Scholar
Rutstein, S. O. & Shah, I. H. (2004) Infecundity, Infertility, and Childlessness in Developing Countries. DHS Comparative Report No. 9, ORC Macro and WHO, Calverton, MD, USA.Google Scholar
Sundaram, R., Mumford, S. L., Louis, B. & Germaine, M. (2017) Couples’ body composition and time-to-pregnancy. Human Reproduction 32(3), 662–668.CrossRefGoogle ScholarPubMed
Sundby, J. (2002) Infertility and health care in countries with less resources. In Inhorn M. C. & Van Balen, F. (eds) Infertility around the Globe: New Thinking on Childlessness, Gender, and Reproductive Technologies. University of California Press, London, pp. 247–259.Google Scholar
Swanton, A. & Child, T. (2005) Reproduction and ovarian ageing. Journal of the British Menopause Society 11, 126–131.CrossRefGoogle ScholarPubMed
Taşçı, E., Bolsoy, N., Kavlak, O. & Yüceso, F. (2008) Marital adjustment in infertile women. Turkish Journal of Obstetrics and Gynecology 5, 105–110.Google Scholar
Terävä, A. N., Gissler, M., Hemminki, E. & Luoto, R. (2008) Infertility and the use of infertility treatments in Finland: prevalence and socio-demographic determinants 1992–2004. European Journal of Obstetrics & Gynecology and Reproductive Biology 136, 61–66.CrossRefGoogle ScholarPubMed
Thoma, M. E., McLain, A. C., Louis, J. F., King, R. B., Trumble, A. C., Sundaram, R. & Louis, G. M. B. (2013) Prevalence of infertility in the United States as estimated by the current duration approach and a traditional Constructed Approach. Fertility & Sterility 99, 1324–1331.CrossRefGoogle Scholar
Unisa, S. (2010) Infertility and treatment seeking in India: findings from district level household survey. Facts, Views & Visions in ObGyn, Monograph, 59–65.Google Scholar
Urman, B. & Yakin, K. (2010) New Turkish legislation on assisted reproductive techniques and centres: a step in the right direction? Reproductive Biomedicine Online 21, 729–731.Google Scholar
van Noord-Zaadstra, B. M., Looman, C. W., Alsbach, H., Habbema, J. D., te Velde, E. & Karbatt, J. (1991) Delaying childbearing: effect of age on fecundity and outcome of pregnancy. British Medical Journal 302, 1361–1365.Google Scholar
WHO (2001) Reproductive Health Indicators for Global Monitoring: Report of the Second Interagency Meeting. Department of Reproductive Health and Research Family and Community Health, Geneva.Google Scholar