Time-to-Pregnancy and Associated Factors among Couples with Natural Planned Conception in Addis Ababa, Ethiopia.

Waiting time-to-pregnancy (TTP) of couples is closely related to fecundability. Knowledge on TTP helps clinicians to individualize care for sub-fertility/infertility. Published studies on TTP are very limited in African setting. This cross-sectional study assessed TTP and associated factors among couples with natural planned conception in Addis Ababa, Ethiopia. Data was collected interviewing a representative sample of 1150 pregnant women. The mean and median TTPs were 6.4 (±9.4) and 3.0 months respectively. Only 11.8% (136/1,150) achieved pregnancy in the first month of attempt. Majority, 81.7% (938/1,150), achieved pregnancy by 12 months. The odds of sub-fecundity (TTP more than 12 months) was lowest in age group of 25-29 years (AOR 0.37; 95% CI 0.20-0.70). Women working more than 60 hours/week (AOR 1.87; 95% CI 1.02-3.42), who drink more than 3 cups of coffee/day (AOR 1.87; 95% CI 1.02-3.42), and whose partners chew khat (AOR 1.66; 95% CI 1.06-2.60) had significantly higher odds of sub-fecundity. Use of contraceptive implants (AOR 0.28; 95% CI 0.15-0.51) and pills (AOR 0.53; 95% CI 0.32-0.89) before the index pregnancy had significantly lower odds of sub-fecundity. This study did not consider amount, duration and frequency of khat chewing, hence its dose dependent effect on fecundability/TTP needs further investigation.

Prevalence and correlates of infertility related psychological stress in women with infertility: a cross-sectional hospital based survey.

BACKGROUND: Psychological stress is commonly found among infertile women. Untreated stress can affect negatively the success of infertility treatment. Most of the available knowledge is generated from developed countries and is largely based on women undergoing In vitro fertilization (IVF) treatment. However, very little is known on infertile women from Ethiopia including other countries in East Africa. The aim of this study was to determine the prevalence of psychological stress and possible demographic-clinical correlates in Ethiopian women suffering from infertility. METHOD: This cross sectional descriptive correlation study was conducted from May to August, 2021 involving 96 women undergoing a non-IVF treatment for infertility at Gandhi Memorial and Tikur Anbessa hospitals. The sampling was continuous and based on inclusion criteria that include infertility duration of a minimum one year, female sex and Ethiopian nationality. Data on Infertility related stress was collected using the Copenhagen Multi-Centre Psychosocial Infertility-Fertility Problem Stress questionner administered by an interviewer. The socio demographic and clinical factors were collected using Amharic version of structured interviewer administered questionnaire and chart review. The analysis of relationship between infertility related stress and background variables was done with an independent sample t-test or one-way ANOVA statistics supplemented with effect size assessment. RESULTS: The prevalence of infertility related stress was overall 92.71% (95% CI, 87-98%). The personal, marital, and social subdomain mean scores (SD) were 2.74 (.80), 1.54 (.81) and 1.90 (.80), respectively. Infertility related stress was higher for those women who were: aged above 35, living in a cohabitation marital type, has no living children, and with 4-6 years duration of infertility (all P < 0.05). Whereas, there was insufficient evidence to suggest that infertility related stress varies by education, income, knowledge of cause of infertility or history of past treatment (all P > 0.05). CONCLUSIONS: The prevalence of psychological stress among Ethiopia women having infertility was very high. The results provide preliminary evidence that infertility related stress is associated with age, marital status, motherhood status and duration of infertility. Responsible bodies need to avail psychological screening and services prioritizing women at higher risk of developing stress.