The Prevalence of Infertility among Iranian Women: An Overview of Systematic Reviews and Meta- Analyses

Background: Understanding the magnitude of infertility is critical for monitoring, assessing, and improving equitable access to fertility care services, as well as addressing risk factors of infertility. This study aims to estimate the prevalence of infertility and associated factors among Iranian women.
Materials and Methods: In this overview, online databases Medline, EMBASE, Web of Science, Scopus, Cochrane Library, CINAHL, CIVILICA, and Google search engine were searched for related systematic and meta-analysis studies published up to January 2024. Two independent scholars undertook the screening, selection, and quality assessment of selected research (using the AMSTAR tool).
Results: A total of five systematic reviews (including 95 studies, n= 279717 women) were included. The results indicated that the current prevalence of infertility in Iran is 13.2% (ranged 7.8-13.2%), primary infertility is 10.6% (ranged: 3.09-18.3%), secondary infertility is 3.2% (ranged: 2-3.2%), and current infertility is 3.7% (ranged: 2.2-3.7%). The prevalence of primary and secondary infertility by gender was higher in women than in men (6% and 3%, respectively, p<0.05). The prevalence of primary infertility was more common in women under the age of 35 (p<0.05). Subgroup analysis of current infertility prevalence was significant based on year (p<0.05). The prevalence of causes related to ovulation, uterine tubes, and endometriosis in infertile women was estimated at 54.0%. 
Conclusion: The prevalence of infertility among women (1990 to 2019) has decreased over time. Primary infertility is higher than secondary infertility and more common in women under the age of 35. For both women and men, however, lifestyle factors such as smoking, excessive alcohol intake, and obesity have been associated with higher chances of infertility.