{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:09:02Z","timestamp":1789499342672,"version":"build-2803163510"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medicine"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study aimed to explore the epidemiology and characteristics of primary versus secondary infertility cases referred to infertility clinics at a major Saudi Arabian referral hospital, as well as potential correlations between patients\u2019 characteristics and infertility types.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>All female patients who visited the infertility clinics between January 2020 and December 2022 were included in this retrospective chart review study. Data were collected on medical histories, medications, diagnostic tests, reproductive characteristics, and the type and cause of infertility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      During the study period, a total of 667 female patients attended the infertility clinic. The mean age was 33.64\u2009\u00b1\u20096.56\u2009years. The mean marriage duration was 79.92\u2009\u00b1\u200957.17\u2009months, and the mean duration of infertility was 59.80\u2009\u00b1\u200949.71\u2009months. Of the total patients, 56.07% had secondary infertility, whereas 43.93% had primary infertility. The most frequently defined causes were unexplained, followed by combined factors. Temporal patterns show a gradual, but significant decrease in cases during the COVID-19 pandemic peak months (25.82% reduction between January and April). Results from diagnostic tests were generally normal for most patients. Females with secondary infertility tended to be older (Mean age\u2009=\u200934.64 vs 32.37\u2009years) and had been married for longer (Mean duration 96.18 vs 68.86\u2009months;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -value\u2009&lt;\u20090.001). The duration of infertility was longer for patients with primary infertility. An irregular menstrual cycle was more common in females with the primary type of infertility. Individuals with secondary infertility were significantly more likely to have had previous surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Crucial information in the epidemiology of infertility has been found. The older age among secondary infertility, as well as the high proportion of unknown causes warrants further research. Women\u2019s health consultants and family physicians should initiate investigations and manage underlying causes during the waiting period for specialized clinic appointments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20503121251352065","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T02:45:47Z","timestamp":1751510747000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Primary versus secondary infertility: Epidemiology and characteristics from a referral hospital in Saudi Arabia"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8049-237X","authenticated-orcid":false,"given":"Nouf A","family":"AlShamlan","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4899-7965","authenticated-orcid":false,"given":"Reem S","family":"AlOmar","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman Abdulrazzaq","family":"Alfryyan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, King Fahd University Hospital, Dammam, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulsalam Essam","family":"Almuhanna","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Alkhobar Health Network, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AlJawhara Raed","family":"AlSaadoun","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halah Raaed","family":"AlMuhaidib","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Ghazi","family":"Alhaidari","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Madinah Health Cluster, King Fahad Hospital, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakan Saud","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Dammam Medical Complex, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah H","family":"Alreedy","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nouf A","family":"AlTooq","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amani S","family":"AlOtaibi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"World Health Organization. Infertility. Geneva Switzerland: WHO https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/infertility (2024 accessed 16 March 2025)."},{"issue":"4","key":"e_1_3_3_3_2","first-page":"425","article-title":"1 in 6 people globally affected by infertility: WHO","volume":"44","author":"World Health Organization","year":"2023","unstructured":"World Health Organization. 1 in 6 people globally affected by infertility: WHO. Saudi Med J 2023; 44(4): 425.","journal-title":"Saudi Med J"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2020.103173"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2022.43.10.20220411"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-057132"},{"issue":"6","key":"e_1_3_3_7_2","first-page":"623","article-title":"Infertility: evaluation and management","volume":"107","author":"Phillips K","year":"2023","unstructured":"Phillips K, Olanrewaju RA, Omole F. Infertility: evaluation and management. Am Fam Phys 2023; 107(6): 623\u2013630.","journal-title":"Am Fam Phys"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20031692"},{"key":"e_1_3_3_9_2","unstructured":"Kingdom of Saudi Arabia. General authority for statistics. Population Estimates 2024 https:\/\/www.stats.gov.sa\/documents\/20117\/2067012\/Population+Estimates+Publication+2024 (2024 accessed 13 May 2025)."},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.NPR.0000660356.18430.0a"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.4103\/jhrs.JHRS_140_18"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mefs.2015.02.001"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.736942"},{"key":"e_1_3_3_14_2","first-page":"87","article-title":"Etiology of infertility and treatment outcome in couples aged 40 years or more in a non-IVF setting","volume":"9","author":"Al Abdali FH","year":"2021","unstructured":"Al Abdali FH, Gowri V. Etiology of infertility and treatment outcome in couples aged 40 years or more in a non-IVF setting. 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