INFERTILITY IN A COMMUNITY AND CLINIC-BASED SAMPLE OF COUPLES IN MOSHI, NORTHERN TANZANIA

Abstract

Background: Previous research on the aetiology of infertility in sub-Saharan Africa was
generally clinic based and it is not known whether findings from this work are
representative of the general population. A better understanding of the medical causes
of infertility is crucial for reducing the incidence of infertility and for improving the
clinical management.
Objective: To determine the type and aetiology of infertility in a community and clinicbased
sample.
Design: Couples identified as infertile in a representative cross-sectional survey from
a community-based sample of 2019 women aged 20-44 years and couples seeking care
for infertility at a tertiary health facility.
Setting: The community-based sample was drawn from Moshi Urban District and the
clinic-based sample from patients seeking care at Kilimanjaro Christian Medical Centre
(KCMC) in 2002 and 2003.
Participants: Sixty six couples identified as infertile in the community-based sample and
112 couples seeking care for infertility.
Results: The percentage of primary infertility was 37.1% and secondary infertility was
62.9%. Female only factor infertility was identified in 65.9% of the couples, male only
factor in 6.8%, male and female factors in 15.2% and unexplained infertility in 12.1%.
Conclusion: The type and aetiology of infertility were the same in the community and
clinic-based sample suggesting that the couples seeking infertility health care were
representative of the general infertile population. Tubal factor infertility was the
commonest cause.