The relationship between infertility and intentional delay of childbearing

The relationship between infertility and intentional delay of childbearing | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The relationship between infertility and intentional delay of childbearing Marzie sheikhian, faranak safdari - dehcheshmeh, Maryam lotfi pur, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4337079/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : The use of contraceptive methods and intentional delay of childbearing and their relationship with infertility are important questions in the minds of couples and health service providers. Objective: This study aimed to investigate the relationship between infertility and intentional delay of childbearing and the duration of contraceptive use in couples. Materials and methods : This was a case-control study on 290 couples referring to the Al-Zahra infertility center, Shahrekord, Iran and Health Centers Number 1 and 5 of Shahrekord from May to August 2022 using a systematic random sampling method. Data were collected through a checklist and analyzed using SPSS software version 18. Chi-square test, Fisher’s exact test, and independent t -test were used with a significance level < 0.05. Results : The results of the study showed that there was no difference in intentional delay of childbearing (the duration of contraceptive use) between the case and control groups. The most common contraceptive method used by both groups was the whithdrawal method. The use of condoms and OCP was significantly higher in the control group, and the use of IUD was significantly higher in the case group. Conclusion : The results showed that the duration of contraceptive use was not associated with infertility, but the type of contraceptive was associated with infertility. This finding can also be used in the field of couples counseling. However, due to the contradictions and ambiguities in this area and the limitations of this study, further research in this field is recommended. infertility delay pregnancy contraception Introduction Infertility is a multifactorial phenomenon ( 1 ) and is divided into two types, primary and secondary, with different causes on the female and male sides and also causes that are unknown ( 2 ). Infertility is recognized as a devastating problem worldwide and can cause economic deprivation, social isolation, and grief ( 3 ). It can also lead to psychological complications and disorders within families and may eventually lead to divorce ( 2 ). Marriage delay and intentional delay of childbearing are considered causes of infertility ( 4 ). The World Health Organization estimates that one in six couples experience delay in pregnancy, and the trend is increasing ( 5 ). Iran has experienced a decline in fertility in recent years ( 6 ). If this trend continues, the country will face serious consequences, such as decline in young labor force and aging of population ( 7 ). One reason couples choose to intentionally delay childbearing is unfavorable financial and psychological conditions. Couples intentionally delay conception until they can support their children financially and psychologically ( 8 ). The most important reasons for the decline in fertility are the postponement of the first birth and longer intervals between births ( 9 , 10 ). One study found that couples who used contraceptive methods for more than two years had an increased risk of infertility ( 11 ). On the other hand, some studies have concluded that intentional delay of childbearing is not associated with fertility ( 12 – 14 ). A study by Noronha et al. (2022) found no association between the duration of contraceptive use and the return of fertility ( 15 ) although the results of some studies suggest that the use of some contraceptive methods may lead to infertility ( 16 – 18 ). However, several studies have not been able to confirm the association between infertility and contraceptive use ( 19 – 22 ). In addition, most people believe that using contraceptives during childbearing age and before childbearing may exacerbate infertility ( 23 ) and therefore avoid using contraceptives for fear of infertility ( 24 – 26 ). However, if health service providers use the correct educational methods and educate clients on these topics, they may prevent complications caused by these methods ( 27 ). Therefore, there is a lack of complete information about the relationship between the duration of intentional delay of childbearing and the type of contraceptive method with the occurrence of infertility in couples. To identify the existing problems, the first step is to examine the duration of married life, the duration of intentional delay of childbearing, and the duration of contraception use in these women. This can give a comprehensive overview of the challenges in this area and allow us to present more scientific and evidence-based solutions to solve these problems. Given the few studies conducted on this subject and the contradictory results of the studies, the current study was designed aiming to investigate the relationship between infertility and intentional delay of childbearing and the duration of contraceptive use. Materials and methods This case-control study was conducted on 290 couples (fertile and infertile) after obtaining the necessary permits at Al-Zahra Infertility Center of Shahrekord and Health Centers Number 1 and 5 of Shahrekord, Iran from May to August 2022. One hundred and 45 infertile couples with medical records at Al-Zahra Infertility Center of Shahrekord and 145 fertile couples covered by comprehensive health centers of Shahrekord were included in the study using systematic (regular) random sampling method following the sample size formula: The case group was selected by random sampling method, by referring to Al-Zahra Infertility Center of Shahrekord (It is the only infertility clinic in Shahrekord), selecting the samples among the files in the infertility clinic, and collecting the desired information from the information recorded in the files; if incomplete, the information was completed by making a phone call to the phone number recorded in the file. The control group was selected using the convenience sampling method (In order to match the control group with the case group, this sampling method was used in the control group), by referring to Health Centers Number 1 and 5 of Shahrekord, because they covered a high population and were located in two geographically different places. The convenience sampling method was used for selecting the control group to match the samples with the case group among eligible couples with the same criteria (couple`s marital age, presence or absence of underlying medical conditions and alcohol, drug, or tobacco use). The required information was obtained through the information recorded in the couple`s medical file, and if the checklist questions were not filled, the information was completed by making a phone call to the phone number recorded in the file. Inclusion criteria included age range of 17–49 years, diagnosed infertility in the case group, current pregnancy or breastfeeding or having a child and no previous history of infertility diagnosis in the control group,not suffering from diseases such as hypothyroidism and diabetes, and the willingness to participate in the study. The exclusion criteria were failure to complete all items of the checklist. Data were collected using checklists that included common couple characteristics such as age, length of the marriage, contraceptive methods, and the duration of using contraceptive methods (the measure of intentional delay of childbearing). Variables such as infertility duration, type of infertility, and cause of infertility were specific to the case group, and the number of pregnancies, the age of the last child, and the number of children were specific to the control group. Statistical analysis Data were analyzed using Version 18 SPSS software (SPSS Inc., Chicago, IL). and the chi-square test, Fisher’s exact test, and independent t -test with a significance level < 0.05. Results The study was conducted on 290 couples, including 145 infertile couples and 145 fertile couples. The studied samples were homogenous in terms of marital age, drug, alcohol, and tobacco use, and the presence or absence of underlying medical conditions. The average marriage duration in the case group (about 8 years) was also significantly longer than in the control group (about 6 years), but both groups were homogeneous in terms of marriage age (Table I). The results of the present study indicated that the most commonly used contraception method in both groups (case: 50.3%, control: 46.2%) was the whithdrawal method and the control group significantly used more condoms and pills and less IUDs than the case group ( P < 0.05). The use of injectable contraceptive in both groups was similar and showed no difference (Table II), and the duration of contraceptive use (the measure of intentional delay of childbearing) was not significantly different between the groups (Table I). Table I- Relationship of demographic variables in the studied groups Quantitative variables Groups P-Value Qualitative variables Groups P-Value Case (Total number:145(100)) mean ± S.d Control (Total number:145(100)) mean ± S.d Case (Total number:145(100)) Frequency (%) Control (Total number:145(100)) Frequency (%) Marital Age (years) 24.52 ± 6.45 24.65 ± 4.88 0.854 addiction Drug alcohol Smoking No addiction 0(0) 0(0) 0(0) 145(100) 0(0) 0(0) 0(0) 145(100) 1.000 Husband's age (years) 36.70 ± 7.32 35.38 ± 5.82 0.089 Husband's addiction Drug alcohol Smoking No addiction 0(0) 0(0) 13( 9 ) 132(91) 0(0) 0(0) 13( 9 ) 132(91) 1.000 Marital Age of husband' (years) 28.74 ± 6.72 29.07 ± 5.22 0.640 underlying disease has it does not have 11(7.6) 134(92.4) 11(7.6) 134(92.4) 1.000 Length of marriage (months) 95.39 ± 65.03 77.51 ± 57.23 *0.014 Type of disease does not have diabetes Hypothyroidism high blood pressure anemia 134(92.4) 3(2.1) 5(3.4) 2(1.4) 1(0.7) 134(92.4) 3(2.1) 5(3.4) 2(1.4) 1(0.7) 1.000 Duration of using contraceptive methods (months) 34.52 ± 32.23 41.30 ± 36.67 0.139 Presence of current pregnancy Yes no 1(0.7) 144(99.3) 89(66.4) 56(38.6) *<0.001 ……………. ……………. ……………. ……… Duration of Infertility Less than 1 year 1–5 years 5–10 years More than 10 years 17(11.7) 77(53.1) 32(22.1) 19(13.1) 0(0) 0(0) 0(0) 0(0) *p < 0.05, Chi-square test and independent t test. Table II- Relationship of the types of contraceptive methods with the studied groups Type of contraceptive method Groups P-Value Case (Total number:145(100)) Frequency (%) Case (Total number:145(100)) Frequency (%) condoms 20(13.8) 35(24.1) *<0.001 F Pills 6(4.1) 25(17.2) injectable (one-month and three-month ampoule) 2(1.4) 2(1.4) IUD 3(2.1) 2(1.4) Whithdrawal 73(50.3) 67(46.2) Lack of contraception 41(28.3) 14(9.7) *p < 0.05, F: Fisher exact test Abbreviations: IUD: Intrauterine device. Discussion This study was a descriptive-analytical case-control study aimed to investigate the association between infertility and intentional delay of childbearing and the type and duration of contraceptive use among infertile couples referring to the Al-Zahra Infertility Center of Shahrekord in 2022. The results of the present study indicated that the most commonly used contraception method in both groups (case: 50.3%, control: 46.2%) was the whithdrawal method. In this regard, studies have produced many conflicting findings. Two studies conducted in Iran are in line with the present study, stating that the most commonly used contraception method by the studied samples was the whithdrawal method ( 28 , 29 ), while contradictory results can be seen in other studies, with condoms and IUDs rated as the most commonly used methods of contraception in some studies ( 30 , 31 ). A study by Esmailizadeh and colleagues. (2012) reported that oral contraceptive pills (OCP) were the most commonly used method by fertile and infertile couples to prevent pregnancy ( 6 ). The contradictions between these studies and the present study may be due to differences in study type and sample size; this study is a case-control study, whereas the study by Esmaeilizadeh was a descriptive epidemiology study with a large sample size. On the other hand, this study looked at all types of contraceptive methods, whereas the study by Esmaeilizadeh looked at OCP, IUD, and tubal ligation methods, which could be another reason for the difference in the results of these studies. The study results showed no statistical association between the duration of contraceptive use (intentional delay of childbearing) and infertility. The results of most of the studies were in line with our findings ( 13 , 14 ), e.g., the duration of using various contraceptive methods in the study by Noronha and co-workers. (2022) was not related to the fertility return rate ( 15 ), and the duration of using contraceptive methods was not even related to the type of infertility, i.e. primary or secondary infertility ( 12 ). However, another study found a significant association between the duration of contraceptive use and infertility, reporting that couples using contraceptive methods for more than two years had an increased risk of infertility ( 11 ). The contradiction between this study and our study may be due to the difference in the study type and sample size; the present study was a case-control, while the other study was cross-sectional descriptive. The difference in the type of data collection may be another cause of this contradiction because most of the data of the present study was obtained from the data recorded in the participants’ files while in the other study, the data were collected through interviews. The present study found a significant association between the type of contraceptive method and infertility, with the control group using more condoms and pills and fewer IUDs than the case group, but there was no difference in terms of the use of injectable contraception between the groups. The results of most of the studies on the types of contraceptives used were in conflict with the results of the present study. In the study by Esmaeilizadeh and co-authors. (2012), the use of birth control pills, IUD, and tubal ligation was significantly higher in the control group compared to the case group ( 6 ). The results from another study in Yazd showed no association between IUD use and infertility ( 21 ). The results of a study by Noronha and co-workers. (2022) also suggested that there was no difference between the use of different types of hormonal and non-hormonal contraceptives in terms of the duration of fertility return ( 15 ). The contradictions between these studies with and present study may be due to the different type of study; while the other studies were cross-sectional and cohort, ours was a case-control study. Differences in sample sizes and sampling methods can also be the reason for contradictions. Conclusion The results indicated that the duration of contraceptive use was not associated with infertility, but the type of contraceptive method was. Although the aforementioned findings can be used in the field of couples counseling, due to the contradictions and ambiguities in this field and the limitations of the present study, we recommend that further studies with different sample sizes and different study types be conducted in this field. Declarations Acknowledgments The authors of the article express their appreciation and gratitude to all those who helped us in the implementation of this research, the research vice-chancellor of Rafsanjan University of Medical Sciences and the treatment and research vice-chancellor of Shahrekord University of Medical Sciences. This study was financially supported by Rafsanjan University of Medical Sciences, Rafsanjan, Iran. Funding Rafsanjan University of Medical Sciences, Iran , Grant Id :400172. Data availability All data and supplementary material are available upon request from the corresponding author. Authors information Authors and Affiliations Department of Midwifery , School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran, Marzie sheikhian (M.Sc.) Department of Midwifery and reproductive Health, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran, faranak safdari - dehcheshmeh * (Ph.D) Department of Midwifery , School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran, , Maryam lotfi pur (M.Sc.) Department of Midwifery , School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran, marzeyeh loripoor (Ph.D) Author Contributions Marzieh Sheikhian proposed the project and also helped in collecting samples and writing the article and submitting the article to the journal. Maryam Lotfi pur and Marzieh Loripoor collaborated in revising the research plan. faranak safdari – dehcheshmeh collaborated in revising the research plan and article and submitting the article to the journal. Corresponding author Correspondence to faranak safdari – dehcheshmeh Ethical declaration Ethical consideration This research is approved by the Research Council of Rafsanjan University of Medical Sciences, Rafsanjan, Iran with the code of ethics IR.RUMS.REC.1400.173. The samples participated in the study after signing the informed consent form. Consent for publication Not applicable. Conflicts of interests The authors declare that they have no conflicts interests. References Li X, Ye L, Tian L, Huo Y, Zhou M. Infertility-Related stress and life satisfaction among chinese infertile women: a moderated mediation model of marital satisfaction and resilience. Sex Roles. 2020;82(1):44–52. Hasanpoor-Azghdy SB, Simbar M, Vedadhir A. The emotional-psychological consequences of infertility among infertile women seeking treatment: Results of a qualitative study. Iran J reproductive Med. 2014;12(2):131. Hollos M, Whitehouse B. 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Afr J Reprod Health. 2015;19(4):31–40. Klinger A, Asgary R. Perceptions and attitudes regarding sexually transmitted infection and family planning among adolescents in northern Madagascar. Women Health. 2017;57(5):599–613. Lowdermilk DL, Perry SE, Cashion MC, Alden KR, Olshansky E. Maternity and Women's Health Care E-Book: Elsevier Health Sciences; 2019. Karami F, Gholami F, Ghasemi A. Prevalence of Contraceptive Use and Different Factors Influencing its Choice among Women in Tehran, Iran. J Midwifery Reproductive Health. 2021;9(4):3017–22. Amiri F, Rafiei M, Najafi R. Study of fertility and use of pregnancy contraceptive methods in women referring to remedial centers in Arak city in 2017. J Arak Univ Med Sci. 2019;22(3):1–10. Siddiqui M, Fatima K, Ali SN, Fatima M, Naveed W, Siddiqui F et al. Prevalence and predictors of contraception usage in Karachi, Pakistan. Cureus. 2020;12(10). Erfani A. Curbing publicly-funded family planning services in Iran: who is affected? J Family Plann Reproductive Health Care. 2017;43(1):37–43. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4337079","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":309285536,"identity":"aa85d20c-6218-4d87-938d-9e2a1d586709","order_by":0,"name":"Marzie sheikhian","email":"","orcid":"","institution":"Rafsanjan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Marzie","middleName":"","lastName":"sheikhian","suffix":""},{"id":309285537,"identity":"281bad31-1562-4b00-8357-33e51de814fb","order_by":1,"name":"faranak safdari - dehcheshmeh","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABB0lEQVRIiWNgGAWjYBAC9gYwlcDAwHzAgIHBwAbIYWw8gE8LzwGYFrYEkJY0kJYGUrQwHAZz8WthP/vwc0FNmj1/G/PGzxUF5+3Wth8G2lJjE41TC0+6sfSMYzmJM46xFUueMbidvO1MIlDLsbTcBhxa7BnSGKR52CoSGO73GEg2ALWYHQBqYWw4jFMLD/8z5t88/yrs5Y/xGP9sMDiXbHb+IQEtEmls0rxtOYwbjvGYAW05YGd2g5AtEs/YrHn70hI3HmMrs2wwSE4wuwG0JQGPX3j405hv83xLtpc7xrz5ZsMfO3uz8+kPH3yoscGpBQMkglUmEKscBOxJUTwKRsEoGAUjAwAA5nFfXVs3rJkAAAAASUVORK5CYII=","orcid":"","institution":"Shahrekord University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"faranak","middleName":"safdari -","lastName":"dehcheshmeh","suffix":""},{"id":309285538,"identity":"6cde3f7d-fef2-48f9-8a56-766ec26b3eeb","order_by":2,"name":"Maryam lotfi pur","email":"","orcid":"","institution":"Rafsanjan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Maryam","middleName":"lotfi","lastName":"pur","suffix":""},{"id":309285539,"identity":"b5ec5bf4-9787-4f4d-8124-e0dc2f206e55","order_by":3,"name":"marzeyeh loripoor","email":"","orcid":"","institution":"Rafsanjan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"marzeyeh","middleName":"","lastName":"loripoor","suffix":""}],"badges":[],"createdAt":"2024-04-28 08:51:46","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4337079/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4337079/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":57798548,"identity":"822cc8c3-8c72-480a-a1b0-c0e9fecb648f","added_by":"auto","created_at":"2024-06-05 20:27:44","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":598924,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4337079/v1/0bbe428f-0883-4d3a-83a4-bd51f15a392d.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The relationship between infertility and intentional delay of childbearing","fulltext":[{"header":"Introduction","content":"\u003cp\u003eInfertility is a multifactorial phenomenon (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) and is divided into two types, primary and secondary, with different causes on the female and male sides and also causes that are unknown (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Infertility is recognized as a devastating problem worldwide and can cause economic deprivation, social isolation, and grief (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). It can also lead to psychological complications and disorders within families and may eventually lead to divorce (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMarriage delay and intentional delay of childbearing are considered causes of infertility (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). The World Health Organization estimates that one in six couples experience delay in pregnancy, and the trend is increasing (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Iran has experienced a decline in fertility in recent years (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). If this trend continues, the country will face serious consequences, such as decline in young labor force and aging of population (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). One reason couples choose to intentionally delay childbearing is unfavorable financial and psychological conditions. Couples intentionally delay conception until they can support their children financially and psychologically (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). The most important reasons for the decline in fertility are the postponement of the first birth and longer intervals between births (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). One study found that couples who used contraceptive methods for more than two years had an increased risk of infertility (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). On the other hand, some studies have concluded that intentional delay of childbearing is not associated with fertility (\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). A study by Noronha et al. (2022) found no association between the duration of contraceptive use and the return of fertility (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e) although the results of some studies suggest that the use of some contraceptive methods may lead to infertility (\u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). However, several studies have not been able to confirm the association between infertility and contraceptive use (\u003cspan additionalcitationids=\"CR20 CR21\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). In addition, most people believe that using contraceptives during childbearing age and before childbearing may exacerbate infertility (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) and therefore avoid using contraceptives for fear of infertility (\u003cspan additionalcitationids=\"CR25\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). However, if health service providers use the correct educational methods and educate clients on these topics, they may prevent complications caused by these methods (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTherefore, there is a lack of complete information about the relationship between the duration of intentional delay of childbearing and the type of contraceptive method with the occurrence of infertility in couples. To identify the existing problems, the first step is to examine the duration of married life, the duration of intentional delay of childbearing, and the duration of contraception use in these women. This can give a comprehensive overview of the challenges in this area and allow us to present more scientific and evidence-based solutions to solve these problems. Given the few studies conducted on this subject and the contradictory results of the studies, the current study was designed aiming to investigate the relationship between infertility and intentional delay of childbearing and the duration of contraceptive use.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cp\u003eThis case-control study was conducted on 290 couples (fertile and infertile) after obtaining the necessary permits at Al-Zahra Infertility Center of Shahrekord and Health Centers Number 1 and 5 of Shahrekord, Iran from May to August 2022.\u003c/p\u003e\n\u003cp\u003eOne hundred and 45 infertile couples with medical records at Al-Zahra Infertility Center of Shahrekord and 145 fertile couples covered by comprehensive health centers of Shahrekord were included in the study using systematic (regular) random sampling method following the sample size formula:\u003c/p\u003e\n\u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u0026nbsp;\u003c/span\u003e\u003cimg 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\"\u003e\u003c/p\u003e\n\u003cp\u003eThe case group was selected by random sampling method, by referring to Al-Zahra Infertility Center of Shahrekord (It is the only infertility clinic in Shahrekord), selecting the samples among the files in the infertility clinic, and collecting the desired information from the information recorded in the files; if incomplete, the information was completed by making a phone call to the phone number recorded in the file.\u003c/p\u003e\n\u003cp\u003eThe control group was selected using the convenience sampling method (In order to match the control group with the case group, this sampling method was used in the control group), by referring to Health Centers Number 1 and 5 of Shahrekord, because they covered a high population and were located in two geographically different places. The convenience sampling method was used for selecting the control group to match the samples with the case group among eligible couples with the same criteria (couple`s marital age, presence or absence of underlying medical conditions and alcohol, drug, or tobacco use).\u003c/p\u003e\n\u003cp\u003eThe required information was obtained through the information recorded in the couple`s medical file, and if the checklist questions were not filled, the information was completed by making a phone call to the phone number recorded in the file.\u003c/p\u003e\n\u003cp\u003eInclusion criteria included age range of 17–49 years, diagnosed infertility in the case group, current pregnancy or breastfeeding or having a child and no previous history of infertility diagnosis in the control group,not suffering from diseases such as hypothyroidism and diabetes, and the willingness to participate in the study.\u003c/p\u003e\n\u003cp\u003eThe exclusion criteria were failure to complete all items of the checklist.\u003c/p\u003e\n\u003cp\u003eData were collected using checklists that included common couple characteristics such as age, length of the marriage, contraceptive methods, and the duration of using contraceptive methods (the measure of intentional delay of childbearing). Variables such as infertility duration, type of infertility, and cause of infertility were specific to the case group, and the number of pregnancies, the age of the last child, and the number of children were specific to the control group.\u003c/p\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eStatistical analysis\u003c/h2\u003e\n \u003cp\u003eData were analyzed using Version 18 SPSS software (SPSS Inc., Chicago, IL). and the chi-square test, Fisher’s exact test, and independent \u003cem\u003et\u003c/em\u003e-test with a significance level \u0026lt; 0.05.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe study was conducted on 290 couples, including 145 infertile couples and 145 fertile couples. The studied samples were homogenous in terms of marital age, drug, alcohol, and tobacco use, and the presence or absence of underlying medical conditions. The average marriage duration in the case group (about 8 years) was also significantly longer than in the control group (about 6 years), but both groups were homogeneous in terms of marriage age (Table I).\u003c/p\u003e \u003cp\u003eThe results of the present study indicated that the most commonly used contraception method in both groups (case: 50.3%, control: 46.2%) was the whithdrawal method and the control group significantly used more condoms and pills and less IUDs than the case group (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05). The use of injectable contraceptive in both groups was similar and showed no difference (Table II), and the duration of contraceptive use (the measure of intentional delay of childbearing) was not significantly different between the groups (Table I).\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable I- Relationship of demographic variables in the studied groups\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"±\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"±\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e\u003ccolgroup cols=\"8\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eQuantitative variables\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eGroups\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-Value\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eQualitative variables\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eGroups\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-Value\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase\u003c/p\u003e \u003cp\u003e(Total number:145(100))\u003c/p\u003e \u003cp\u003emean ± S.d\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003cp\u003e(Total number:145(100))\u003c/p\u003e \u003cp\u003emean ± S.d\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCase\u003c/p\u003e \u003cp\u003e(Total number:145(100))\u003c/p\u003e \u003cp\u003eFrequency (%)\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003cp\u003e(Total number:145(100))\u003c/p\u003e \u003cp\u003eFrequency (%)\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital Age (years)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\"±\" colname=\"c2\"\u003e \u003cp\u003e24.52 ± 6.45\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\"±\" colname=\"c3\"\u003e \u003cp\u003e24.65 ± 4.88\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.854\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eaddiction\u003c/b\u003e\u003c/p\u003e \u003cp\u003eDrug\u003c/p\u003e \u003cp\u003ealcohol\u003c/p\u003e \u003cp\u003eSmoking\u003c/p\u003e \u003cp\u003eNo addiction\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003cp\u003e145(100)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003cp\u003e145(100)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHusband's age (years)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\"±\" colname=\"c2\"\u003e \u003cp\u003e36.70 ± 7.32\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\"±\" colname=\"c3\"\u003e \u003cp\u003e35.38 ± 5.82\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.089\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eHusband's addiction\u003c/b\u003e\u003c/p\u003e \u003cp\u003eDrug\u003c/p\u003e \u003cp\u003ealcohol\u003c/p\u003e \u003cp\u003eSmoking\u003c/p\u003e \u003cp\u003eNo addiction\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003cp\u003e13(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e132(91)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003cp\u003e13(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e132(91)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital Age of husband' (years)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\"±\" colname=\"c2\"\u003e \u003cp\u003e28.74 ± 6.72\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\"±\" colname=\"c3\"\u003e \u003cp\u003e29.07 ± 5.22\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.640\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eunderlying disease\u003c/b\u003e\u003c/p\u003e \u003cp\u003ehas it\u003c/p\u003e \u003cp\u003edoes not have\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11(7.6)\u003c/p\u003e \u003cp\u003e134(92.4)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e11(7.6)\u003c/p\u003e \u003cp\u003e134(92.4)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLength of marriage (months)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\"±\" colname=\"c2\"\u003e \u003cp\u003e95.39 ± 65.03\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\"±\" colname=\"c3\"\u003e \u003cp\u003e77.51 ± 57.23\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e*0.014\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eType of disease\u003c/b\u003e\u003c/p\u003e \u003cp\u003edoes not have\u003c/p\u003e \u003cp\u003ediabetes\u003c/p\u003e \u003cp\u003eHypothyroidism\u003c/p\u003e \u003cp\u003ehigh blood pressure\u003c/p\u003e \u003cp\u003eanemia\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e134(92.4)\u003c/p\u003e \u003cp\u003e3(2.1)\u003c/p\u003e \u003cp\u003e5(3.4)\u003c/p\u003e \u003cp\u003e2(1.4)\u003c/p\u003e \u003cp\u003e1(0.7)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e134(92.4)\u003c/p\u003e \u003cp\u003e3(2.1)\u003c/p\u003e \u003cp\u003e5(3.4)\u003c/p\u003e \u003cp\u003e2(1.4)\u003c/p\u003e \u003cp\u003e1(0.7)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of using contraceptive methods (months)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\"±\" colname=\"c2\"\u003e \u003cp\u003e34.52 ± 32.23\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\"±\" colname=\"c3\"\u003e \u003cp\u003e41.30 ± 36.67\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.139\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003ePresence of current pregnancy\u003c/b\u003e\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(0.7)\u003c/p\u003e \u003cp\u003e144(99.3)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e89(66.4)\u003c/p\u003e \u003cp\u003e56(38.6)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e*\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e…………….\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e…………….\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e…………….\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e………\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eDuration of Infertility\u003c/b\u003e\u003c/p\u003e \u003cp\u003eLess than 1 year\u003c/p\u003e \u003cp\u003e1–5 years\u003c/p\u003e \u003cp\u003e5–10 years\u003c/p\u003e \u003cp\u003eMore than 10 years\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e17(11.7)\u003c/p\u003e \u003cp\u003e77(53.1)\u003c/p\u003e \u003cp\u003e32(22.1)\u003c/p\u003e \u003cp\u003e19(13.1)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e \u003cp\u003e\u003c/p\u003e \u003cp\u003e*p \u0026lt; 0.05, Chi-square test and independent t test.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable II- Relationship of the types of contraceptive methods with the studied groups\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e\u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eType of contraceptive method\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eGroups\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-Value\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase\u003c/p\u003e \u003cp\u003e(Total number:145(100))\u003c/p\u003e \u003cp\u003eFrequency (%)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCase\u003c/p\u003e \u003cp\u003e(Total number:145(100))\u003c/p\u003e \u003cp\u003eFrequency (%)\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003econdoms\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20(13.8)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35(24.1)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e*\u0026lt;0.001 F\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePills\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6(4.1)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25(17.2)\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003einjectable (one-month and three-month ampoule)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(1.4)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(1.4)\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIUD\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(2.1)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(1.4)\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhithdrawal\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e73(50.3)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67(46.2)\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLack of contraception\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41(28.3)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14(9.7)\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003e*p \u0026lt; 0.05, F: Fisher exact test\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e \u003cp\u003e\u003c/p\u003e\u003cp\u003eAbbreviations: IUD: Intrauterine device.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study was a descriptive-analytical case-control study aimed to investigate the association between infertility and intentional delay of childbearing and the type and duration of contraceptive use among infertile couples referring to the Al-Zahra Infertility Center of Shahrekord in 2022.\u003c/p\u003e\u003cp\u003eThe results of the present study indicated that the most commonly used contraception method in both groups (case: 50.3%, control: 46.2%) was the whithdrawal method.\u003c/p\u003e\u003cp\u003eIn this regard, studies have produced many conflicting findings. Two studies conducted in Iran are in line with the present study, stating that the most commonly used contraception method by the studied samples was the whithdrawal method (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e), while contradictory results can be seen in other studies, with condoms and IUDs rated as the most commonly used methods of contraception in some studies (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). A study by Esmailizadeh and colleagues. (2012) reported that oral contraceptive pills (OCP) were the most commonly used method by fertile and infertile couples to prevent pregnancy (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe contradictions between these studies and the present study may be due to differences in study type and sample size; this study is a case-control study, whereas the study by Esmaeilizadeh was a descriptive epidemiology study with a large sample size. On the other hand, this study looked at all types of contraceptive methods, whereas the study by Esmaeilizadeh looked at OCP, IUD, and tubal ligation methods, which could be another reason for the difference in the results of these studies.\u003c/p\u003e\u003cp\u003eThe study results showed no statistical association between the duration of contraceptive use (intentional delay of childbearing) and infertility.\u003c/p\u003e\u003cp\u003eThe results of most of the studies were in line with our findings (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e), e.g., the duration of using various contraceptive methods in the study by Noronha and co-workers. (2022) was not related to the fertility return rate (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e), and the duration of using contraceptive methods was not even related to the type of infertility, i.e. primary or secondary infertility (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). However, another study found a significant association between the duration of contraceptive use and infertility, reporting that couples using contraceptive methods for more than two years had an increased risk of infertility (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe contradiction between this study and our study may be due to the difference in the study type and sample size; the present study was a case-control, while the other study was cross-sectional descriptive. The difference in the type of data collection may be another cause of this contradiction because most of the data of the present study was obtained from the data recorded in the participants’ files while in the other study, the data were collected through interviews.\u003c/p\u003e\u003cp\u003eThe present study found a significant association between the type of contraceptive method and infertility, with the control group using more condoms and pills and fewer IUDs than the case group, but there was no difference in terms of the use of injectable contraception between the groups.\u003c/p\u003e\u003cp\u003eThe results of most of the studies on the types of contraceptives used were in conflict with the results of the present study. In the study by Esmaeilizadeh and co-authors. (2012), the use of birth control pills, IUD, and tubal ligation was significantly higher in the control group compared to the case group (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). The results from another study in Yazd showed no association between IUD use and infertility (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). The results of a study by Noronha and co-workers. (2022) also suggested that there was no difference between the use of different types of hormonal and non-hormonal contraceptives in terms of the duration of fertility return (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe contradictions between these studies with and present study may be due to the different type of study; while the other studies were cross-sectional and cohort, ours was a case-control study. Differences in sample sizes and sampling methods can also be the reason for contradictions.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe results indicated that the duration of contraceptive use was not associated with infertility, but the type of contraceptive method was. Although the aforementioned findings can be used in the field of couples counseling, due to the contradictions and ambiguities in this field and the limitations of the present study, we recommend that further studies with different sample sizes and different study types be conducted in this field.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors of the article express their appreciation and gratitude to all those who helped us in the implementation of this research, the research vice-chancellor of Rafsanjan University of Medical Sciences and the treatment and research vice-chancellor of Shahrekord University of Medical Sciences.\u003c/p\u003e\n\u003cp\u003eThis study was financially supported by Rafsanjan University of Medical Sciences, Rafsanjan, Iran.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRafsanjan University of Medical Sciences, Iran\u003c/strong\u003e\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003eGrant Id :400172.\u003c/p\u003e\n\u003ch2\u003eData availability\u003c/h2\u003e\n\u003cp\u003eAll data and supplementary material are available upon request from the corresponding author.\u003c/p\u003e\n\u003ch3\u003eAuthors information\u003c/h3\u003e\n\u003cp\u003eAuthors and Affiliations\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDepartment of Midwifery\u003c/strong\u003e\u003cstrong\u003e, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran,\u0026nbsp;\u003c/strong\u003eMarzie sheikhian (M.Sc.)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDepartment of Midwifery and reproductive Health,\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;School of Nursing and Midwifery, Shahrekord\u0026nbsp;University of Medical Sciences, Shahrekord, Iran,\u003c/strong\u003e faranak safdari - dehcheshmeh\u003csup\u003e\u003cspan dir=\"RTL\"\u003e*\u003c/span\u003e\u003c/sup\u003e (Ph.D)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDepartment of Midwifery\u003c/strong\u003e\u003cstrong\u003e, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran,\u0026nbsp;\u003c/strong\u003e, Maryam lotfi pur (M.Sc.)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDepartment of Midwifery\u003c/strong\u003e\u003cstrong\u003e, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran,\u0026nbsp;\u003c/strong\u003emarzeyeh loripoor (Ph.D)\u003c/p\u003e\n\u003ch2\u003eAuthor Contributions\u003c/h2\u003e\n\u003cp\u003eMarzieh Sheikhian\u0026nbsp;proposed the project and also helped in collecting samples and writing the article and submitting the article to the journal. Maryam Lotfi pur and Marzieh Loripoor collaborated in revising the research plan. faranak safdari \u0026ndash; dehcheshmeh\u0026nbsp; collaborated in revising the research plan and article and submitting the article to the journal.\u003c/p\u003e\n\u003ch2\u003eCorresponding author\u003c/h2\u003e\n\u003cp\u003eCorrespondence to faranak safdari \u0026ndash; dehcheshmeh\u003c/p\u003e\n\u003ch2\u003eEthical declaration\u003c/h2\u003e\n\u003cp\u003e\u003cstrong\u003eEthical consideration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research is approved by the Research Council of Rafsanjan University of Medical Sciences, Rafsanjan, Iran with the code of ethics IR.RUMS.REC.1400.173.\u003c/p\u003e\n\u003cp\u003eThe samples participated in the study after signing the informed consent form.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflicts interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLi X, Ye L, Tian L, Huo Y, Zhou M. 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J Clin Diagn research: JCDR. 2014;8(10):OC13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHammadeh ME, Fischer-Hammadeh C, Ali KR. Assisted hatching in assisted reproduction: a state of the art. J Assist Reprod Genet. 2011;28(2):119\u0026ndash;28.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEsmaeilzadeh S, Delavar MA, Zeinalzadeh M, Mir M-RA. Epidemiology of infertility: a population-based study in Babol. Iran Women health. 2012;52(8):744\u0026ndash;54.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMcDonald P, Hosseini-Chavoshi M, Abbasi-Shavazi MJ, Rashidian A. An assessment of recent Iranian fertility trends using parity progression ratios. Demographic Res. 2015;32:1581\u0026ndash;602.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSilumbwe A, Nkole T, Munakampe MN, Milford C, Cordero JP, Kriel Y, et al. Community and health systems barriers and enablers to family planning and contraceptive services provision and use in Kabwe District, Zambia. BMC Health Serv Res. 2018;18(1):1\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHosseini-Chavoshi M, Abbasi-Shavazi MJ, McDonald P. Fertility, marriage, and family planning in Iran: Implications for future policy. Popul Horizons. 2016;13(1):31\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhou Z, Zheng D, Wu H, Li R, Xu S, Kang Y, et al. Epidemiology of infertility in China: a population-based study. BJOG: Int J Obstet Gynecol. 2018;125(4):432\u0026ndash;41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKhatun N, Mondal MNI, Islam MR, Hossain MK, Parvin MN, Hossen MS et al. Factors associated with infertility among married women in Rajshahi City, Bangladesh.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVICTOR O. FINDINGS IN SUBFERTILE WOMEN UTILIZING HYSTEROSALPINGOGRAPHY SERVICES AT THE MOI. TEACHING AND REFERRAL HOSPITAL, ELDORET, KENYA.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMansour D, Gemzell-Danielsson K, Inki P, Jensen JT. Fertility after discontinuation of contraception: a comprehensive review of the literature. Contraception. 2011;84(5):465\u0026ndash;77.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAstato E, Djajadilaga D. Factors Affecting Selection of Contraceptive Methods and Its Length of Use. Indonesian J Obstet Gynecol. 2015:94\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNoronha QM, Nurinasari H, Budihastuti UR. Return of Fertility After Discontinuation of Contraception According Type of Contraception, Duration of Use, Age and BMI. Indonesian J Obstet Gynecol. 2022:37\u0026ndash;41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGirum T, Wasie A. Return of fertility after discontinuation of contraception: a systematic review and meta-analysis. Contracept reproductive Med. 2018;3(1):1\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNDATA CW, UGWU FC, FACTORS ASSOCIATED WITH INFERTILITY AMONG WOMEN ATTENDING THE GYNAECOLOGY, CLINIC OF THE UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL, RIVERS STATE. J Res Dev Stud. 2019;3(1):1\u0026ndash;14.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlian F, Montazeral-Qaem A, Ahmadvand Z, Kasiri M. Methods of Pregnancy Prevention and Prohibition from the Perspective of Muslim Physicians (from the 3rd to the 9th Century AH). J Res History Med. 2019;8(4):213\u0026ndash;28.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eErfani A. Curbing family planning in Iran: an appraisal of Bill 446. J Family Plann Reproductive Health Care. 2015;41(4):317\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbdinasab M, Firouzabadi RD, Farajkhoda T, Abdoli AM. Lack of association between Cu T-380A intrauterine device and secondary infertility in Iran. Int J fertility Steril. 2017;10(4):343.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBerek J. DL B. Berek \u0026amp; Novak\u0026rsquo;s Gynecology 16th edition. Berek JS, editor. Philadelphia: Wolters Kluwer; 2020.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBornstein M, Huber-Krum S, Norris AH, Gipson JD, Infertility. Perceived Certainty of Pregnancy, and Contraceptive Use in Malawi. Studies in Family Planning. 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSedlander E, Bingenheimer JB, Thiongo M, Gichangi P, Rimal RN, Edberg M, et al. They destroy the reproductive system: exploring the belief that modern contraceptive use causes infertility. Stud Fam Plann. 2018;49(4):345\u0026ndash;65.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOchako R, Mbondo M, Aloo S, Kaimenyi S, Thompson R, Temmerman M, et al. Barriers to modern contraceptive methods uptake among young women in Kenya: a qualitative study. BMC Public Health. 2015;15(1):1\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchwandt HM, Skinner J, Hebert LE, Saad A. Perceived risks associated with contraceptive method use among men and women in Ibadan and Kaduna, Nigeria. Afr J Reprod Health. 2015;19(4):31\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKlinger A, Asgary R. Perceptions and attitudes regarding sexually transmitted infection and family planning among adolescents in northern Madagascar. Women Health. 2017;57(5):599\u0026ndash;613.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLowdermilk DL, Perry SE, Cashion MC, Alden KR, Olshansky E. Maternity and Women's Health Care E-Book: Elsevier Health Sciences; 2019.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKarami F, Gholami F, Ghasemi A. Prevalence of Contraceptive Use and Different Factors Influencing its Choice among Women in Tehran, Iran. J Midwifery Reproductive Health. 2021;9(4):3017\u0026ndash;22.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmiri F, Rafiei M, Najafi R. Study of fertility and use of pregnancy contraceptive methods in women referring to remedial centers in Arak city in 2017. J Arak Univ Med Sci. 2019;22(3):1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSiddiqui M, Fatima K, Ali SN, Fatima M, Naveed W, Siddiqui F et al. Prevalence and predictors of contraception usage in Karachi, Pakistan. Cureus. 2020;12(10).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eErfani A. Curbing publicly-funded family planning services in Iran: who is affected? J Family Plann Reproductive Health Care. 2017;43(1):37\u0026ndash;43.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"infertility, delay, pregnancy, contraception","lastPublishedDoi":"10.21203/rs.3.rs-4337079/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4337079/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: The use of contraceptive methods and intentional delay of childbearing and their relationship with infertility are important questions in the minds of couples and health service providers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e This study aimed to investigate the relationship between infertility and intentional delay of childbearing and the duration of contraceptive use in couples.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterials and methods\u003c/strong\u003e: This was a case-control study on 290 couples referring to the Al-Zahra infertility center, Shahrekord, Iran and Health Centers Number 1 and 5 of Shahrekord from May to August 2022 using a systematic random sampling method. Data were collected through a checklist and analyzed using SPSS software version 18. Chi-square test, Fisher’s exact test, and independent \u003cem\u003et\u003c/em\u003e-test were used with a significance level \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: The results of the study showed that there was no difference in intentional delay of childbearing (the duration of contraceptive use) between the case and control groups. The most common contraceptive method used by both groups was the whithdrawal method. The use of condoms and OCP was significantly higher in the control group, and the use of IUD was significantly higher in the case group.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The results showed that the duration of contraceptive use was not associated with infertility, but the type of contraceptive was associated with infertility. This finding can also be used in the field of couples counseling. However, due to the contradictions and ambiguities in this area and the limitations of this study, further research in this field is recommended.\u003c/p\u003e","manuscriptTitle":"The relationship between infertility and intentional delay of childbearing","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-05 09:18:00","doi":"10.21203/rs.3.rs-4337079/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"732f1fbc-766e-4149-a7f1-99a296a3b0c5","owner":[],"postedDate":"June 5th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-06-05T20:24:35+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-05 09:18:00","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4337079","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4337079","identity":"rs-4337079","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}