Difference between Primary and Secondary Infertility in Morocco: Frequencies and Associated Factors.

Background: The main objective of this survey was to determine the difference between primary and secondary infertility in Morocco and the associated factors among women, who are referred to public and private health centers in Morocco. MATERIALS AND METHODS: In this cross-sectional study, 619 infertile women referring to public and private health centers in Marrakech-Safi region, were selected by simple random sampling method. This study was conducted between 1 October 2013 and 31 December 2015. Socio-economic status, demographic characteristics, couple's age, nutritional status and other data related to both male and female reproductive organs were collected by a questionnaire. Logistic regression was used to identify the associated factors to infertility. Statistical significance was set at 0.05. RESULTS: The rates of primary and secondary infertility were 67.37, and 32.63%, respectively. Multivariate analysis identified a model with three significant predictive factors of secondary infertility: duration of marriage [odds ratio (OR)=12.263: 2.289-65.685], socio-economic status (OR=3.83: 1.011-14.70) and the ages of women (OR=1.268: 1.038-1.549). CONCLUSION: The causes of primary and secondary infertility were not always a woman's problem, but both man and woman contribute to infertility. Multiple regression analysis showed that women's age, duration of marriage, and socioeconomic status are predictive variables that decrease the chance of fertility among women with secondary infertility.