Consultation and treatment behaviour of infertile couples in China: a population-based study.

Abstract

The prevalence of infertility in couples actively trying to conceive is 25%. What is the consultation-seeking behaviour, diagnosis and related treatment in infertile couples across China? Large cross-sectional population-based study in 2010-2011, in which 25,270 couples from eight provinces/municipalities in China were approached by a multistage stratified cluster sampling strategy. Among the 2680 couples reporting infertility, 1246 infertile couples consulted a fertility doctor. Age of the couple, man's body mass index and women's educational level were found to be associated with consultation behaviour. After the fertility work-up, diagnoses were tubal infertility (n=353, 28.3%), unexplained infertility (n=311, 25.0%), male infertility (n=234, 18.8%), ovulatory disorder (n=194, 15.6%) and endometriosis (n=34, 2.7%), while 8.6% (n=107) were not classified. Most couples received non-assisted reproductive technology (ART) fertility treatment (n=906, 89.3%), with a proportion using traditional Chinese medicine (TCM) (n=298, 29.4%). Intrauterine insemination (n=62, 6.1%) and IVF/intracytoplasmic sperm injection (n=57, 5.6%) were less frequent. Medical treatment and outcomes among five subtypes of infertility were also reported: about 30% of couples with unexplained infertility (n=94, 30.3%) or male infertility (n=67, 29.0%) used TCM to treat infertility. Apart from patients with endometriosis, of whom 20.6% (n=7) received ART, patients with other infertility subtypes rarely received ART. For subsequent fertility outcome, 94% of them did not achieve a pregnancy. The prevalence of infertility in China is high, but the uptake of treatment is relatively low.