{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:55:51Z","timestamp":1777312551950,"version":"3.51.4"},"reference-count":84,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021]]},"abstract":"Background\/aim: Infertility is defined as the inability of heterosexual couples to achieve a successful clinically recognizable pregnancy after 12 months or more of regular, unprotected sexual intercourse. Infertility estimations are very important to inform the healthcare policymakers and governments to implement appropriate social and economic policies. Thus, this study aimed to estimate the pooled prevalence of infertility (primary and secondary) and its etiologic factors in Sudan.<\/jats:p>\n Methods: This study included all published and unpublished studies written in Arabic or English. Electronic sources (namely, PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov) and nonelectronic sources (direct Google search, Google Scholar, OpenGrey, OATD, WorldCat log, and university websites) were used from their inception to May 16, 2021. A total of 1955 studies were reviewed, of which only 20 studies were eligible for the meta-analysis. Studies were eligible if they provided the prevalence of infertility in Sudan. The Joanna Briggs Institute Quality Assessment Tool was used to evaluate each study. Data synthesis and statistical analysis were conducted using Jeffrey's Amazing Statistics Program version 0.14.1.0.<\/jats:p>\n \n Results: The pooled prevalence of overall infertility, primary infertility, and secondary infertility in Sudan were 13% (I\n 2<\/jats:sup>\n \u00a0=\u00a096.45,\n p<\/jats:italic>\n \u00a0<\u00a00.001), 65% (I\n 2<\/jats:sup>\n \u00a0=\u00a098.5,\n p<\/jats:italic>\n \u00a0<\u00a00.001), and 35% (I\n 2<\/jats:sup>\n \u00a0=\u00a098.5,\n p<\/jats:italic>\n \u00a0<\u00a00.001), respectively, and the prevalence of infertility factors were 41%, 27%, 16%, and 17% for female, male, combined factors, and unexplained factors, respectively. Women with infertility were mainly present because of ovulatory disorders (ovulatory factors, 36%; polycystic ovary syndrome, 38%). By contrast, spermatic disorders such as azoospermia (37%), oligozoospermia (30%), and asthenozoospermia (30%) were the main causes of male infertility.\n <\/jats:p>\n Conclusion: In Sudan, the prevalence of primary infertility is higher than that of secondary infertility. Female factors were the most common causes of infertility in Sudan, and this study found a high prevalence of unexplained factors. Polycystic ovary syndrome and azoospermia were the most common causes of female and male infertility in Sudan, respectively. The interpretation of these findings should take into consideration the presence of substantial heterogeneity between the included studies.<\/jats:p>","DOI":"10.5339\/qmj.2021.47","type":"journal-article","created":{"date-parts":[[2021,11,26]],"date-time":"2021-11-26T10:30:49Z","timestamp":1637922649000},"source":"Crossref","is-referenced-by-count":11,"title":["Prevalence of infertility in Sudan: A systematic review and meta-analysis"],"prefix":"10.5339","volume":"2021","author":[{"given":"Abdullah","family":"A. A.","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Musa","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adesina","family":"Oladokun","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"key":"CIT0001","article-title":"Infertility definitions and terminology [World Health Organization global, Geneva, Switzerland, 4 February 2020]4"},{"key":"CIT0002","article-title":"Speroff's clinical gynecologic endocrinology and infertility: Lippincott Williams & Wilkins;","year":"2019"},{"key":"CIT0003"},{"issue":"(3):","key":"CIT0004","series-title":"IOSR Journal of Nursing and Health Science,\u00a0NHS","first-page":"28\u201331","article-title":"Causes of infertility among Sudanese women in Khartoum State Sudan\u00a02013","year":"2013:\u00a06"},{"issue":"(2):","key":"CIT0005","series-title":"Int J Gynaecol Obstet","first-page":"S4\u2013S8","article-title":"The changing prevalence of infertility","volume":"123","year":"2013,"},{"issue":"(3):","key":"CIT0006","series-title":"Cochrane Database Syst Rev","first-page":"CD011345","article-title":"Timed intercourse for couples trying to conceive","author":"Manders\n \nM\n,","year":"2015"},{"issue":"(23):","key":"CIT0007","first-page":"10952\u201310991","article-title":"Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990\u20132017: results from a global burden of disease study, 2017","volume":"11","year":"2019"},{"issue":"(3):","key":"CIT0008","series-title":"Afr J Reprod Health","first-page":"9-17","article-title":"High prevalence of male infertility in Africa: are mycotoxins to blame?","volume":"19","year":"2015"},{"issue":"(1):","key":"CIT0009","series-title":"Fertil Res Pract","first-page":"1\u201311","article-title":"Primary and secondary infertility in Africa: systematic review with meta-analysis","volume":"6","year":"2020"},{"key":"CIT0010","series-title":"Facts, Views & Vision in ObGyn","article-title":"Reviewing infertility care in Sudan; socio-cultural, policy and ethical barriers","author":"Khalifa\n \nDA\n,","year":"2012"},{"issue":"(1):","key":"CIT0011","series-title":"Fertil Res Pract","first-page":"1\u20135","article-title":"Epidemiology of infertility and characteristics of infertile couples requesting assisted reproduction in a low-resource setting in Africa, Sudan","volume":"5","year":"2019"},{"issue":"(4):","key":"CIT0012","series-title":"Trop Doct","first-page":"243\u2013244","article-title":"Clinical patterns and major causes of infertility among Sudanese couples","volume":"38","year":"2008"},{"issue":"(589):","key":"CIT0013","series-title":"F1000 Research","first-page":"589\u2013602","article-title":"Cytological and molecular screening of Chlamydia trachomatis in infertile women attending a maternity teaching hospital in Gezira State, Sudan: a cross-sectional study","volume":"9","author":"Omer\n \nHMH\n,","year":"2020;"},{"issue":"4:","key":"CIT0014","series-title":"F1000 Research","first-page":"1339\u20131350","article-title":"Maternal age and intracytoplasmic sperm injection outcome in infertile couples at Khartoum, Sudan","year":"2015"},{"issue":"(1):","key":"CIT0015","series-title":"MOJ Women's Health","first-page":"107\u2013108","article-title":"Prevalence of primary infertility among selected group of Sudanese women with infertility disorders","volume":"8","author":"Hussein\n \nM\n,","year":"2019;"},{"issue":"(2):","key":"CIT0016","series-title":"Soc Sci Med","first-page":"209\u2013220","article-title":"Patterns and predictors of infertility among African women: a cross-national survey of twenty-seven nations","volume":"42","year":"1996"},{"issue":"(2):","key":"CIT0017","series-title":"Int J Epidemiol","first-page":"285\u2013291","article-title":"Primary and secondary infertility in sub-Saharan Africa","volume":"29","year":"2000"},{"issue":"(2):","key":"CIT0018","series-title":"Med J Cairo Univ","first-page":"529\u2013532","article-title":"Pattern of infertility among couples in Gezira Area, Sudan","volume":"79","year":"2011"},{"issue":"(1):","key":"CIT0019","series-title":"Research Journal of Medical Sciences","first-page":"56\u201360","article-title":"Epidemiology of infertility in Gezira region, central of Sudan","volume":"5","year":"2011"},{"key":"CIT0020","article-title":"Study of Female Infertility in Sudanese using Ultrasonography. PhD, Sudan University of Science and Technology, Sudan, 2019"},{"issue":"(3):","key":"CIT0021","series-title":"Sudanese Journal of Public Health","first-page":"340\u2013344","article-title":"Semen analysis of infertile Sudanese males in Gezira state central Sudan","volume":"4","author":"Ahmed\n \nM\n,","year":"2009;"},{"key":"CIT0022","article-title":"Pattern of infertility among Sudanese couples attending at police university hospital, PhD, university of Khartoum, Sudan, 2003","author":"Abdel\n \nRahman\n,"},{"key":"CIT0023"},{"key":"CIT0024"},{"key":"CIT0025"},{"key":"CIT0026"},{"key":"CIT0027"},{"issue":"(8):","key":"CIT0028","series-title":"Australian Journal of Basic and Applied Sciences","first-page":"1449\u20131455","article-title":"Correlation of Aspirated Peritoneal Fluid Findings at Laparoscopy and Tubal Pathology in Infertile Women","volume":"5","author":"Nabag\n \nW.O.M.\n,","year":"2011;"},{"key":"CIT0029","series-title":"Eur J Obstet Gynaecol","article-title":"Prevalence of female infertility in four regions in the Sudan","author":"Elsheikh\n \nM.A.\n,"},{"key":"CIT0030","article-title":"Critical Appraisal tools for use in JBI Systematic Reviews [Internet]"},{"issue":"(7414):","key":"CIT0031","series-title":"BMJ","first-page":"557\u2013560","article-title":"Measuring inconsistency in meta-analyses","volume":"327","year":"2003"},{"key":"CIT0032"},{"issue":"(4):","key":"CIT0033","series-title":"Urol J","first-page":"338\u2013345","article-title":"Prevalence of infertility in Iran: a systematic review and meta-analysis","volume":"17","year":"2020"},{"issue":"(6):","key":"CIT0034","series-title":"Obstet Gynecol Int J","first-page":"503\u2013505","article-title":"Situation of sexually transmitted infections (STIs) in Sudan","volume":"9","author":"Mohamed Elawad\n \nNA","year":"2018"},{"issue":"(1):","key":"CIT0035","series-title":"Virology J","first-page":"1\u201316","article-title":"Systematic review and meta-analysis of HIV, HBV and HCV infection prevalence in Sudan","volume":"15","year":"2018"},{"issue":"(2):","key":"CIT0036","series-title":"Libyan J Med","first-page":"37","article-title":"Infertility in the Middle East and North Africa Region: a systematic review with meta-analysis of prevalence surveys","volume":"2","year":"2018"},{"issue":"(11):","key":"CIT0037","series-title":"Int J Mol Sci","first-page":"2720","article-title":"Animal models for human polycystic ovary syndrome (PCOS) focused on the use of indirect hormonal perturbations: a review of the literature","volume":"20","year":"2019"},{"issue":"(3):","key":"CIT0038","series-title":"Cochrane Database Syst Rev","first-page":"1\u201390","article-title":"Lifestyle changes in women with polycystic ovary syndrome","year":"2019"},{"issue":"(1):","key":"CIT0039","series-title":"Fertil Res Pract","first-page":"1\u201310","article-title":"The prevalence of anxiety symptoms in infertile women: a systematic review and meta-analysis","volume":"6","year":"2020"},{"key":"CIT0040"},{"key":"CIT0041"},{"key":"CIT0042"},{"key":"CIT0001","article-title":"Infertility definitions and terminology [World Health Organization global, Geneva, Switzerland, 4 February 2020]4"},{"key":"CIT0002","article-title":"Speroff's clinical gynecologic endocrinology and infertility: Lippincott Williams & Wilkins;","year":"2019"},{"key":"CIT0003"},{"issue":"(3):","key":"CIT0004","series-title":"IOSR Journal of Nursing and Health Science,\u00a0NHS","first-page":"28\u201331","article-title":"Causes of infertility among Sudanese women in Khartoum State Sudan\u00a02013","year":"2013:\u00a06"},{"issue":"(2):","key":"CIT0005","series-title":"Int J Gynaecol Obstet","first-page":"S4\u2013S8","article-title":"The changing prevalence of infertility","volume":"123","year":"2013,"},{"issue":"(3):","key":"CIT0006","series-title":"Cochrane Database Syst Rev","first-page":"CD011345","article-title":"Timed intercourse for couples trying to conceive","author":"Manders\n \nM\n,","year":"2015"},{"issue":"(23):","key":"CIT0007","first-page":"10952\u201310991","article-title":"Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990\u20132017: results from a global burden of disease study, 2017","volume":"11","year":"2019"},{"issue":"(3):","key":"CIT0008","series-title":"Afr J Reprod Health","first-page":"9-17","article-title":"High prevalence of male infertility in Africa: are mycotoxins to blame?","volume":"19","year":"2015"},{"issue":"(1):","key":"CIT0009","series-title":"Fertil Res Pract","first-page":"1\u201311","article-title":"Primary and secondary infertility in Africa: systematic review with meta-analysis","volume":"6","year":"2020"},{"key":"CIT0010","series-title":"Facts, Views & Vision in ObGyn","article-title":"Reviewing infertility care in Sudan; socio-cultural, policy and ethical barriers","author":"Khalifa\n \nDA\n,","year":"2012"},{"issue":"(1):","key":"CIT0011","series-title":"Fertil Res Pract","first-page":"1\u20135","article-title":"Epidemiology of infertility and characteristics of infertile couples requesting assisted reproduction in a low-resource setting in Africa, Sudan","volume":"5","year":"2019"},{"issue":"(4):","key":"CIT0012","series-title":"Trop Doct","first-page":"243\u2013244","article-title":"Clinical patterns and major causes of infertility among Sudanese couples","volume":"38","year":"2008"},{"issue":"(589):","key":"CIT0013","series-title":"F1000 Research","first-page":"589\u2013602","article-title":"Cytological and molecular screening of Chlamydia trachomatis in infertile women attending a maternity teaching hospital in Gezira State, Sudan: a cross-sectional study","volume":"9","author":"Omer\n \nHMH\n,","year":"2020;"},{"issue":"4:","key":"CIT0014","series-title":"F1000 Research","first-page":"1339\u20131350","article-title":"Maternal age and intracytoplasmic sperm injection outcome in infertile couples at Khartoum, Sudan","year":"2015"},{"issue":"(1):","key":"CIT0015","series-title":"MOJ Women's Health","first-page":"107\u2013108","article-title":"Prevalence of primary infertility among selected group of Sudanese women with infertility disorders","volume":"8","author":"Hussein\n \nM\n,","year":"2019;"},{"issue":"(2):","key":"CIT0016","series-title":"Soc Sci Med","first-page":"209\u2013220","article-title":"Patterns and predictors of infertility among African women: a cross-national survey of twenty-seven nations","volume":"42","year":"1996"},{"issue":"(2):","key":"CIT0017","series-title":"Int J Epidemiol","first-page":"285\u2013291","article-title":"Primary and secondary infertility in sub-Saharan Africa","volume":"29","year":"2000"},{"issue":"(2):","key":"CIT0018","series-title":"Med J Cairo Univ","first-page":"529\u2013532","article-title":"Pattern of infertility among couples in Gezira Area, Sudan","volume":"79","year":"2011"},{"issue":"(1):","key":"CIT0019","series-title":"Research Journal of Medical Sciences","first-page":"56\u201360","article-title":"Epidemiology of infertility in Gezira region, central of Sudan","volume":"5","year":"2011"},{"key":"CIT0020","article-title":"Study of Female Infertility in Sudanese using Ultrasonography. 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