The association between female genital cutting and time-to-pregnancy among women of reproductive age - applying the current duration approach in demographic and health survey data from Nigeria

Female genital cutting (FGC) may lead to clinical infertility (failure to achieve apregnancy after 12 months of regular unprotected sexual intercourse) throughgynaecologic morbidity and reduced sexual frequency, but previous studies wereinconclusive. Therefore, we examined if FGC and FGC severity were associated withlonger time-to-pregnancy (TTP) in Nigeria. We restricted 2013 Nigeria DemographicHealth Survey (NDHS) data to women at risk of pregnancy at the time of the interview(18–44 years, married/cohabiting, sexually active, not using contraception, and notsterilised) with self-reported FGC status (n = 4,431). Using the current duration approach,we conducted weighted accelerated-failure-time regression survival modelling toestimate time ratios for TTP by FGC status/severity, stratified by parity as a proxy forprimary (nulliparous) and secondary (parous) infertility. Thirty-three percent of womenreported having undergone FGC (severity: Type I: 2.9%, Type II: 17.7%, Type III: 1.6%,Unknown/missing severity: 10.9%). Overall, there were no differences in TTP betweenthose with and without FGC. However, nulliparous women with Type III FGC had longerTTP (adjTR = 11.80, 95% CI: 4.09–34.01). FGC was not significantly associated withlonger TTP for other severity groups or among parous women.