AUTHOR=Fatima Wafa , Akhtar Abdul Majeed , Hanif Asif , Gilani Aima , Farooq Syed Muhammad Yousaf 

TITLE=Predicted risk factors associated with secondary infertility in women: univariate and multivariate logistic regression analyses

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1327568

DOI=10.3389/fmed.2023.1327568

ISSN=2296-858X

ABSTRACT=Infertile females are those who regularly engaged in unprotected intercourse for a period of at least one year and unable to become clinically pregnant. Primary infertility means that the inability of couples to conceive, without any previous successful pregnancies. Secondary Infertility is referred as the inability to get pregnant for a period of 12 months, after having previously pregnant for one time at least. The objectives of current study were to analyze risk factors for secondary infertility and compare predictive accuracy of Artificial Neural Network (ANN) and Multiple Logistic Regression models. Study was conducted at The University Institute of Public Health collecting data form Gilani Ultrasound Center in 18 months after approval of synopsis. Total 690 females (345 cases and 345 controls) were taken. All females were taken in case group if they are 20-45 years of age, having any parity and confirmed diagnosis of secondary infertility. Multiple logistic regression and artificial neural network was used. The chance of secondary infertility was 2.91 times higher in women living in joint family [odds ratio (OR) = 2.91; 95% confidence interval (CI) (1.91, 4.44)] and was also 2.35 times higher for those females who had relationship difficulties with husband [OR = 2.35; 95% CI (1.18, 4.70)]. Marriage in earlier age was associated with secondary infertility with β is negative and OR is < 1 [OR = 0.94; 95% CI (0.88, 0.99)]. For the logistic regression model, the area under receiver operative characteristic curve (ROC) was 0.852 and for the artificial neural network was 0.87, that was better than logistic regression. Identified risk factors of secondary infertility are mostly modifiable and can be prevented by managing these risk factors.