Prevalence and predictors of primary and secondary infertility in Namibia: A retrospective analysis of clinical records

Background: Infertility is a public health concern affecting many individuals globally. It is defined as the inability to achieve a pregnancy after 12 months or more of uninterrupted and unprotected sexual intercourse and affects both males and females. Primary infertility occurs when conception has never been achieved, while secondary infertility occurs after at least one previous pregnancy has been achieved. Objectives: This study analysed the prevalence and predictors of infertility in Namibia. The research was conducted at four selected public hospitals categorised as central, regional and district. Method: A retrospective and analytical study reviewed 577 hospital records of patients diagnosed with infertility. A structured checklist was developed to extract relevant data, analysed using SPSS version 30 to determine the prevalence and identify predictors of male and female infertility from 2021 to 2023. Ethical approval and permission to access hospital records were obtained from the Namibian Ministry of Health and Social Services and participating hospitals. Results: Of the 577 patient records, secondary infertility was more prevalent (53.6%) than primary infertility (46.4%). Women constituted 79% of cases, with infertility mainly attributed to hormonal imbalances, tubal, uterine factors and ovulation disorders, while male infertility was largely linked to sperm anomalies. One-way analysis of variance indicated significant differences across age, sex, marital status, infertility type, lifestyle and reproductive history (p < 0.05). Multiple regression identified the number of children, sex, age, group, marital status, lifestyle and medication use as significant predictors. Decision tree analysis confirmed parity as the strongest classifier. Conclusion: Secondary infertility was more prevalent, especially among women, with notable variation across sociodemographic and clinical factors. Contribution: The findings contribute to the literature on infertility predictors and prevalence in Namibia. This evidence will be used to structure strategies to support individuals affected by infertility.