medRxiv preprint doi: https://doi.org/10.1101/2021.05.06.21256676; this version posted May 8, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Looking beyond the obvious: a critical systematic review and meta-analyses of risk factors for fertility problems in a globalized world Authors: R.R. Bayoumi1*, J. Boivin2*, H.M. Fatemi3, L. Hurt4, G.I. Serour5, S. van der Poel6 and C. Venetis7. 1* Corresponding author: PhD Student, School of Psychology, Cardiff University, Cardiff, Wales, UK; Takemi Fellow, Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, USA,
[email protected] 2* Corresponding author: Professor of Psychology, School of Psychology, Cardiff University, Cardiff, Wales, UK,
[email protected] 3: Professor of Obstetrics and Gynecology, Group Medical Director, ART Fertility Clinics, Abu Dhabi, UAE 4: Senior Lecturer, Division of Population Medicine, Cardiff University School of Medicine, Cardiff, Wales, UK 5: Professor of Obstetrics and Gynecology, Al Azhar University, Cairo, Egypt 6: Independent Consultant, Route de la Capite, Geneva, Switzerland 7: Associate Professor, Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia Abstract Background: Well-established risk factors for fertility problems such as smoking have been included in fertility awareness efforts globally. However, these efforts neglect risks that women in low and middle-income countries (LMIC) face. Objective: To address this gap, we identified eight risk factors affecting women in LMIC and the aim of the current review was to estimate the impact of these risks on fertility.