title: Knowledge, perceptions and myths regarding infertility among selected adult population in Pakistan: a cross-sectional study.
abstract: BACKGROUND
  The reported prevalence of infertility in Pakistan is approximately 22% with 4% primary and 18% secondary infertility. Infertility is not only a medical but also a social problem in our society as cultural customs and perceived religious dictums may equate infertility with failure on a personal, interpersonal, or social level. It is imperative that people have adequate knowledge about infertility so couples can seek timely medical care and misconceptions can be rectified. We aim to assess the knowledge, perception and myths regarding infertility and suggest ways to improve it.
  
  
  METHODS
  A cross-sectional survey was carried out by interviewing a sample of 447 adults who were accompanying the patients at two tertiary care hospitals in Karachi, Pakistan. They were interviewed one-on-one with the help of a pretested questionnaire drafted by the team after a thorough literature review and in consultation with infertility specialists.
  
  
  RESULTS
  The correct knowledge of infertility was found to be limited amongst the participants. Only 25% correctly identified when infertility is pathological and only 46% knew about the fertile period in women's cycle. People are misinformed that use of IUCD (53%) and OCPs (61%) may cause infertility. Beliefs in evil forces and supernatural powers as a cause of infertility are still prevalent especially amongst people with lower level of education. Seeking alternative treatment for infertility remains a popular option for 28% of the participant as a primary preference and 75% as a secondary preference. IVF remains an unfamiliar (78%) and an unacceptable option (55%).
  
  
  CONCLUSIONS
  Knowledge about infertility is limited in the population and a lot of misconceptions and myths are prevalent in the society. Alternative medicine is a popular option for seeking infertility treatment. The cultural and religious perspective about assisted reproductive technologies is unclear, which has resulted in its reduced acceptability.
authors.affiliation: Medical College, Aga Khan University Stadium Road, Karachi, Pakistan, PO Box 3500. sumerabhojani@hotmail.com
authors.forename: Sumera
authors.initials: S
authors.lastname: Ali
authors.forename: Raafay
authors.initials: R
authors.lastname: Sophie
authors.forename: Ayesha M
authors.initials: AM
authors.lastname: Imam
authors.forename: Faisal I
authors.initials: FI
authors.lastname: Khan
authors.forename: Syed F
authors.initials: SF
authors.lastname: Ali
authors.forename: Annum
authors.initials: A
authors.lastname: Shaikh
authors.forename: Syed
authors.initials: S
authors.lastname: Farid-ul-Hasnain
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D000529:Complementary Therapies; D003267:Contraception; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007246:Infertility / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D010342:Patient Acceptance of Health Care; D027724:Reproductive Techniques, Assisted / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult