Peer-reviewed article
The Relationship between Female Genital Mutilation and Infertility: A systematic review and meta-analysis
N. Soltani, Farahnaz Heshmat, Mohsen Dehghani, Robab Latifnejad Roudsari, Mohadese B Ghalibaf et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review and meta-analysis examined whether female genital mutilation (FGM) is associated with infertility. The researchers searched databases for observational studies and pooled data from three studies involving over 37,000 participants. While the analysis found a 21% increase in the odds of infertility among circumcised women compared to non-circumcised women, this finding was not statistically significant. The review emphasises the importance of efforts to eliminate FGM in young girls.
Key points
- Five analytical cross-sectional studies were identified, with three studies included in the meta-analysis involving 37,146 participants total
- Female circumcision was associated with a 21% increase in odds of infertility (OR = 1.21, 95% CI: 0.98–1.50)
- The relationship between FGM and infertility did not reach statistical significance
- No significant heterogeneity was found between studies (I² = 0.0%)
- The review concludes that efforts to eliminate FGM among young girls should be prioritised
Limitations
The review included only observational cross-sectional studies, which limits causal inference. The meta-analysis pooled only three studies, and the overall finding was not statistically significant, so the strength of evidence for an association is limited.
Abstract
This systematic review aimed to investigate the relationship between female genital mutilation (FGM) and infertility. Online databases were systematically searched up to January 2024 using MeSH keywords to retrieve relevant observational studies. The methodological quality of the analytical cross-sectional studies was assessed using the Newcastle–Ottawa Scale. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated, and a random-effects meta-analysis was used to address any heterogeneity. Additionally, a sensitivity analysis was performed. A total of 5 analytical cross-sectional studies involving 37,146 participants, with 3 studies meeting the criteria for the meta-analysis. The results indicated that female circumcision (FC) was linked to a 21% increase in the odds of developing infertility compared to non-circumcision, although this finding was not statistically significant (OR = 1.21, 95% CI: 0.98–1.50). Notably, there was no evidence of significant heterogeneity between the studies (P = 0.84 [Q statistics], I2 = 0.0%). While a statistically significant relationship between FGM and infertility was not established, the odds of infertility were higher in the circumcised group. Consequently, it is imperative to prioritise efforts to eradicate FC, especially among young girls.