title: The Prevalence and Causes of Primary Infertility in Iran: A Population-Based Study.
abstract: BACKGROUND
  Primary infertility is a health issue among women over the world. The aim of this study was to investigate the prevalence and causes of primary infertility based on a population-based study in an urban area of Iran.
  
  
  METHODS
  In a cross-sectional study, a total of 1067 married women who participated in the Tehran Lipid and Glucose Study were randomly selected using systematic random sampling. Unmarried women, those with unwilling pregnancy and duration of marriage below one year were excluded from the study. Data was collected by using validated ad-hoc questionnaires. Descriptive and inferential statistics were used for data analysis.
  
  
  RESULTS
  The mean (SD) of age and marriage age of the studied women were 40.3 (9.3) and 20.6 (4.49) years, respectively; the overall prevalence of lifetime primary infertility among couples was 17.3% (185/1067). Ovulatory disorder (39.7%) and male factors (29.1%) were the main causes of primary infertility. In addition, 31 (17%) of the women were diagnosed with more than one cause. According to the logistic regression analysis, primary infertility was independently related to the old age of women (OR: 1.37; 95% CI: 1.14-13.63, P.value: 0.001), higher BMI (OR: 1.95; 95% CI: 1.87-4.14, P.value: 0.003), active smoking (OR: 1.47; 95% CI: 1.38-3.53, P.value: 0.012) and higher educational level (OR: 2.23; 95% CI: 1.12-5.53, P.value: 0.03).
  
  
  CONCLUSIONS
  The prevalence of primary infertility in Iran was higher than the worldwide trends of infertility, indicating that understanding such risks help healthcare providers and policy makers to design and implement interventions to slow down this trend.
authors.forename: Hadigheh
authors.initials: H
authors.lastname: Kazemijaliseh
authors.affiliation: . ramezani@endocrine.ac.ir.
authors.forename: Fahimeh
authors.initials: F
authors.lastname: Ramezani Tehrani
authors.forename: Samira
authors.initials: S
authors.lastname: Behboudi-Gandevani
authors.forename: Farhad
authors.initials: F
authors.lastname: Hosseinpanah
authors.forename: Davood
authors.initials: D
authors.lastname: Khalili
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Azizi
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology* / Q000209:etiology*; D007492:Iran / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors