The Relationship between Female Genital Mutilation and Infertility: A systematic review and meta-analysis

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.