Title: Magnitude of infertility and associated factors among women attending selected public
hospitals in Addis Ababa, Ethiopia: A cross-sectional study
Version: 1 Date: 19 Sep 2021
Reviewer:  Temesgen Tilahun
Reviewer's report:
Comments on infertility
1. General comments: the paper is fine and here are some coments
# The language should be edited by native speakers
2. Specific comments
a. Abstract
# Let the conclusion part be more summarized
b. Introduction
# Try to indicate the difference between infertility and subfertility.
# In the last paragraph, the authors indicated that the problem in high in Ethiopia. They also
indicated that there are only few studies in Ethiopia. This seems contradictory and thus, needs
clarification.
# Better if the phrase our country is replaced by Ethiopia
c. Methodology
# The word is not correctly written. In addition, it is better if replaced by methods and materials
# In study design and setting, it is better if authors include whether infertility treatment is given
at private facilities or not
# Study and source population: the authors should clearly state the difference between the two.
It should be rewritten again. According to your description I can’t see any difference
# Obs/gyne= please write its full form
# In exclusion criteria, the authors mentioned” who had tried to conceive for less than one year”.
Do we use one year to define in fertility in all age groups(less than 40 and above 40 years)?. There
are time when we use 6 months as cut-off point. Let the authors clarify this. Those receiving any
form of contraception were also excluded. You mean modern forms of contraception, traditional
forms or all forms?
# In operational definition, let these be included: regular coitus, past and current substance use,
d. Sample size and sampling strategy
# Better rephrased as sample size and sampling technique
# Sample size was determined considering ‘21.2% proportion from a previous study done in
Ethiopia’. Please include the reference
# Let the authors include sampling frame(pictorialy)
# (Obs, /Gyn.)= write its full name
e. Data collection tools and quality control
# ‘Questionnaire was adapted using the reviewed literatures above (22,27)’. The authors used
only two sources to prepare questionnaire. Is that enough? Is that not plagiarism? It needs
clarification.
# ‘The questionnaire was first pre-tested in 5 % of sampled population at Zewditu Hospital’. Le
the authors mention the exact number.
f. Ethics approval and consent to participate
# Put this at its appropriate place( under declaration)
g. Result
# ‘Table 1: Distribution of socio demographic characteristics among women attending obstetric
clinic in three public hospitals in Addis Ababa, Ethiopia, 2021’. The phrase obstetrics clinic
better be replaced by gynecologic clinic. Because we don’t expect infertility cases to visit
obstetric clinic. Or the authors can explain it. The same is true for other tables. Define * under
each table
# Table 1: what is the unit of income? Better if mentioned in dollar
# Is abortion gynecologic or obstetric factor? Let it be placed at the right place.
# Contraception and sexual history are under gynecologic factors. Better if table 3 and 4 are
merged.
h. Discussion
# I can’t see the importance of the 1st paragraph
# In paragraph two, the authors put these(‘The difference might be due to variation in data
collection tool (different measurement scale for measuring infertility), use of different cut-
off points, sample size difference, sampling methods, study setting and study participant’s
variation.’) to explain the difference between their finding and other studies. This needs to be
more specific and to the point. Try to demonstrate how these factors brought the differences
# In paragraph 3, this sentence(….The fallopian tubes are two thin tubes, one on each side of
the uterus, which help lead the mature egg from the ovaries to the uterus.) is not correct. It is
not mature egg cell that goes through the tube to the uterus but the zygote. Therefore, let they
correct this.
i. CONCLUSION AND RECOMMENDATION
# Better if this is rewritten as conclusion
# It is long. Let the authors put it in few sentences
j. Abbreviations
# STL: Sexually Transmitted Disease. This is not correct. Please correct it
# Include these also:HIV, MCH,STI, SPSS,etc
k. Acknowledgement
# There are words like ‘me, my. ‘ it seems the author is one. Please correct it