PIP: Infertility is of particular concern in Africa because of the extent of the problem and the social stigma attached to it. The highest prevalence of infertility in Africa occurs south of the Sahara, but 5-8% of couples are estimated to experience infertility at some point in their reproductive lives (50-80 million people worldwide). The average infertility in Africa is 10.1% of couples, with a high of 32% in some countries, and certain tribes have high infertility rates. While primary infertility is higher in other regions of the world, secondary infertility is more common in Africa, and secondary infertility rates are very complicated to determine. The World Health Organization Task Force on the Diagnosis and Treatment of Infertility instituted a standardized approach to studies of infertility which was adopted in 33 countries. Between 1978 and 1982, a pilot study of this approach examined 8504 couples and found that less than 50% of male and female infertile partners were primarily infertile, and 66% did achieve a pregnancy within the union. The cause of infertility was not determined for 35% of the women and 50% of the infertile men in the sample. Infertility was accounted for by endocrine factors (usually menstrual or ovulatory disturbances) in 35% of infertile cases and tubal factors (such as unilateral or bilateral tubal occlusion, pelvic adhesion, and other abnormalities) in 32%. About 66% of African women experienced tubal factors compared to about 33% worldwide. About 9% of women reported a history of sexually transmitted disease (STD), and 8% reported abortion complications. 46% of men in sub-Saharan Africa reported a history of STDs. About 24% of women with primary infertility and 40% of women with secondary infertility had no previous history of pelvic inflammatory disease or STDs and had tubal disease. African infections are common due to inadequate health services, improper use of antibiotics, and penicillin-resistant strains of gonorrhea. Public health programs should be implemented to prevent infection-related infertility.