Infertility in a community and clinic-based sample of couples in Moshi, Northern Tanzania.

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 clinic-based 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.