The Environmental Study on Assessing the Infertility and its Risk Factors: a Population-based Study of Married Couples in Iran

Solaiman Afroughi, Mehran Pouzesh

Ekoloji, 2019, Issue 107, Pages: 73-79, Article No: e107005


Download Full Text (PDF)


Concerns about the detrimental effects of occupational and environmental exposure on male reproductive function have been raised by reports of declining sperm quality over the last decades. Infertility is a critical problem of couples during reproductive age around the world. This cross-sectional study was conducted from September 2014 to June 2015 in Kohgiluyeh Va Boyer-Aahmad province, Iran. A total of 2284 couples whose women were 19-49 year old through a multistage sampling were randomly selected. Measurements of age, education, occupation, weight and height of men and women, residential place, weather temperature state of the residence region of the couples and the pregnancy history of the wives were gathered. Data were statistically described. Multiple logistic regression analysis was used to detect risk factors for infertility. Statistical significant level was set at 0.05. The prevalence of current infertility among the couples was 10.9% [95% confidence interval (CI): 9.6-12.2]. Woman’s age of 35 years or older [odds ratio (OR)=1.38: 1.03-1.85], resident in regions with hot weather condition (OR=1.47: 1.02-2.11), rural residential state (OR=1.54: 1.13-2.1) and illiteracy of women (OR=1.96: 1.24-3.09) significantly increased the risk of infertility occurrence among the couples. In concluding, Infertility was a concerned health and social problem in the studied population. Rural residential condition, living in regions with hot temperature, illiteracy of woman and the age at 35 years and older in women were detected as the risk factors of infertility presence in the studied couples.


prevalence, infertility, risk factor, couples, temperature, environmental exposure


  • Ardabily HE, Moghadam ZB, Salsali M, Ramezanzadeh F, Nedjat S (2011) Prevalence and risk factors for domestic violence against infertile women in an Iranian setting. Int J Gynecol Obstet 112: 15-17.
  • Babore A, Stuppia L, Trumello C, Candelori C, Antonucci I (2017) Male factor infertility and lack of openness about infertility as risk factors for depressive symptoms in males undergoing assisted reproductive technology treatment in Italy. Fertil Steril 107(4): 1041-7.
  • Barazani Y, Katz BF, Nagler HM, Stember DS (2014) Lifestyle, environment, and male reproductive health. Urol Clin 41(1): 55-66.
  • Barreca A (2017) Does hot weather affect human fertility?. IZA World Labor 357: 1-10.
  • Bell AV (2010) Beyond (financial) accessibility: inequalities within the medicalization of infertility. Sociol Health Illn 32: 631–646.
  • Bhattacharya S, Porter M, Amalraj E, Templeton A, Hamilton M, Lee AJ, Kurinczuk JJ (2009) The epidemiology of infertility in the North East of Scotland. Hum Reprod 24(12): 3096-107.
  • Boivin J, Bunting L, Collins JA, Nygren KG (2007) International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Hum Reprod 22(6): 1506–12.
  • Bushnik T, Cook JL, Yuzpe AA, Tough S, Collins J (2012) Estimating the prevalence of infertility in Canada. Hum Reprod 27(3): 738-46.
  • Datta J, Palmer MJ, Tanton C, Gibson LJ, Jones KG, Macdowall W, Glasier A, Sonnenberg P, Field N, Mercer CH, Johnson AM (2016) Prevalence of infertility and help seeking among 15 000 women and men. Hum Reprod 31(9): 2108-18.
  • Eisenberg ML, Chen Z, Ye A, Louis GM (2015) Relationship between physical occupational exposures and health on semen quality: data from the Longitudinal Investigation of Fertility and the Environment (LIFE) Study. Fertil Steril 103(5): 1271-7.
  • Fisch H, Andrews HF, Fisch KS, Golden R, Liberson G, Olsson CA (2003) The relationship of long term global temperature change and human fertility. Med Hypotheses 61(1): 21-8.
  • Gurunath S, Pandian Z, Anderson RA, Bhattacharya S (2011) Defining infertility—a systematic review of prevalence studies. Hum Reprod Update 17(5): 575-88.
  • Homan GF, Davies M, Norman R (2007) The impact of lifestyle factors on reproductive performance in the general population and those undergoing infertility treatment: a review. Hum Reprod Update 13(3): 209–23.
  • Izmirli GO, Sonmez Y, Sezik M (2014) Prediction of domestic violence against married women in southwestern Turkey. Int J Gynecol Obstet 127(3): 288-92.
  • Kasimovskaya, N. A., Fattakhutdinova, E. V., Khuziakhmetov, A. N., Kutlin, N. G., Kostina, Y. A., Kochetkov, I. G (2018) An attributive component of the condition of people with the diagnosis of “Ischemic heart disease. Effort angina”. Electronic Journal of General Medicine, 15(6), em87.
  • Kazemijaliseh H, Tehrani FR, Behboudi-Gandevani S, Hosseinpanah F, Khalili D, Azizi F (2015) The prevalence and causes of primary infertility in Iran: a population-based study. Glob J Health Sci 7(6): 226.
  • Kim B, Park K, Rhee K (2012). Heat stress response of male germ cells. Cell Mol Life Sci 70(15): 2623–36.
  • Macaluso M, Wright-Schnapp TJ, Chandra A, Johnson R, Satterwhite CL, Pulver A, Berman SM, Wang RY, Farr SL, Pollack LA (2010) A public health focus on infertility prevention, detection, and management. Fertil Steril 93(1): 16-25.
  • Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA (2012). National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med 9(12): e1001356.
  • Omani-Samani R, Amini P, Navid B, Sepidarkish M, Maroufizadeh S, Amir Almasi-Hashiani A (2019) Prevalence of Sexual Dysfunction among Infertile Women in Iran: A Systematic Review and Meta-analysis. Int J Fertil Steril 12(4): 278-283.
  • Pakpour AH, Yekaninejad MS, Zeidi IM, Burri A (2012) Prevalence and risk factors of the female sexual dysfunction in a sample of infertile Iranian women. Arc Gynecol Obstet 286(6): 1589-96.
  • Petraglia F, Serour GI, Chapron C (2013) The changing prevalence of infertility. Int J Gynecol Obstet 123: S4-S8.
  • Ramezanzadeh F, Aghssa MM, Abedinia N, Zayeri F, Khanafshar N, Shariat M, et al (2004). A survey of relationship between anxiety, depression and duration of infertility. BMC Women’s Health 4(1): 9–15.
  • Rouchou B (2013) Consequences of infertility in developing countries. Perspect Public health 133(3): 174-9.
  • Safarinejad MR (2007) Infertility among couples in a population-based study in Iran: prevalence and associated risk factors. Inter Jour Andro 31: 303-14.
  • Schanz S, Reimer T, Eichner M, et al. (2011) Long-term life and partnership satisfaction in infertile patients: A 5-year longitudinal study. Fertil Steril 96: 416-21.
  • Vahidi S, Ardalan A, Mohammad K (2009) Prevalence of primary infertility in the Islamic Republic of Iran in 2004-2005. Asia Pac J Public Health 21(3): 287-93.
  • Volgsten H, Svanberg AS, Ekselius L, Lundkvist Ö, and I. Sundström Poromaa IS (2008) Prevalence of psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment. Hum Reprod 23(9): 2056–63.
  • Webair HH, Ismail TAT, Ismail SB (2018) Patient-centered infertility care from an Arab perspective: A review study. Middle East Fertil Soc J 23: 8-13.
  • Winkelman WD, Katz PP, Smith JF, Rowen TS (2016) The sexual impact of infertility among women seeking fertility care. Sex Med 4(3): 190-7.
  • Tak AZA, Ehi Y (2018) Assessment of Neurological Diagnoses in Patients Applying to the Health Board. J Clin Exp Invest, 9(3):126-30.
  • Zhou Z, Zheng D, Wu H, Li R, Xu S, Kang Y, Cao Y, Chen X, Zhu Y, Chen Z, Mol BW (2017) Prevalence of infertility in China: a population based study. Fertil Steril 108(3): e114.