Abstract
To provide comprehensive estimates of the global, regional, and national burden of infertility from 1990 to 2017, using findings from a 2017 study on the global burden of disease (GBD), we assessed the burden of infertility in 195 countries and territories from 1990 to 2017. DisMod-MR 2.1 is a Bayesian meta-regression method that estimates non-fatal outcomes using sparse and heterogeneous epidemiological data. Globally, the age-standardized prevalence rate of infertility increased by 0.370% per year for females and 0.291% per year for males from 1990 to 2017. Additionally, age-standardized disability-adjusted life-years (DALYs) of infertility increased by 0.396% per year for females and 0.293% per year for males during the observational period. An increasing trend to these burden estimates was observed throughout the all socio-demographic index (SDI) countries. Interestingly, we found that high SDI countries had the lowest level of prevalence and DALYs in both genders. However, the largest increasing trend was observed in high-SDI countries for females. By contrast, low-SDI countries had the largest increasing trend in males. Negative associations were observed between these burden estimates and the SDI level. The global disease burden of infertility has been increasing throughout the period from 1990 to 2017.
Highlights
Infertility is the inability to conceive within 1 year of unprotected intercourse, and it has been identified as a public health priority [1]
The age-standardized prevalence rate of female infertility increased by 14.962% from 1366.85 per 100,000 (95% UI: 988.34, 1819.86) in 1990 to 1571.35 per 100,000 (95% UI: 1115.30, 2121.94) in 2017, representing a shift of 0.370% per year (Figure 1)
The age-standardized prevalence rate of male infertility increased by 8.224% from 710.19 per 100,000 (95% UI: 586.08, 848.94) in 1990 to 768.59 per 100,000 (95% UI: 623.20, 929.91) in 2017, with an increasing rate of 0.291% per year (Figure 2)
Summary
Infertility is the inability to conceive within 1 year of unprotected intercourse, and it has been identified as a public health priority [1]. The Centers for Disease Control and Prevention of the United States emphasizes that infertility is more than a quality-of-life issue, with considerable public health consequences including psychological distress, social stigmatization, economic strain, and marital discord [2, 3]. Infertility affects 15% of couples of reproductive age [4, 5]. A report from the 2006–2010 National Survey of Family Growth estimated that 6% of married females aged 15– 44 years in the United States are infertile, and 12% have impaired fecundity, defined as the inability to conceive and carry a baby to term [6]. Among couples of reproductive age in China, the prevalence of infertility was 25% [7]. Infertility is associated with increased risk of subsequent chronic health conditions such as cardiovascular disease [5]
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