Prevalence of primary and secondary infertility in the Colombo District

Objective: To estimate the prevalence of primary and secondary infertility in the Colombo District Design: A cross sectional survey Setting: District of Colombo Sub jec t s : T w o thousand currently married women of the reproductive age group Measurements : Prevalence of primary and secondary infertility using the WHO definitions. When a woman has never conceived in spite of cohabitation and exposure to pregnancy for a period of twelve months, the condition was defined as p r imary infer t i l i ty . Seconda ry infertility was defined as being present when a woman had previously conceived but had been unable to conceive subsequently despite cohabi tation and exposure to pregnancy for a period of 24 months. If the woman had breast fed the previous infant, then exposure to pregnancy was calculated from the end of the period of lactation amenorrhoea. Results: The point prevalence of primary infer tility was estimated as 40.5 per 1000 married women of the reproductive age group, (95% C.L. 32.0 49.0 per 1000). The prevalence increased progressively with increasing current age and age at marriage of women and their partners and was higher among employed women. The point prevalence of secondary infertility was estimated as 160 per 1000 women of the repro ductive age group, (95% C.L. 143.9 176.0 per 1000). Increasing current age of women and their spouses, higher age at marriage of the male and low socio economic status were associated with increased prevalence. A history suggestive of post partum or post abortal infection was ob tained in 20% of persons who were secondarily infertile. Conclusions: Prevalence of primary infertility is low in the Colombo District, but amounts to an estimated 10,700 16,500 currently married women. The prevalence of secondary infertility is high, with post-partum and post-abortal infec tion contributing to a fifth of the cases.