Epidemiology of infertility in China: a population‐based study

Abstract

ObjectiveTo assess the current prevalence of and risk factors for infertility among couples of reproductive age in China.DesignPopulation‐based cross‐sectional study.SettingWe approached 25 270 couples in eight provinces/municipalities, of whom 18 571 (response rate 74%) were interviewed.PopulationCouples living together and married for more than 1 year, of whom the female spouse was 20–49 years old.MethodsWomen were approached via telephone and face‐to‐face conversation to complete the standardised and structured questionnaire by trained interviewers.Main outcome measuresPrevalence of and risk factors for infertility.ResultsAmong women ‘at risk’ of pregnancy, the prevalence of infertility was 15.5% (2680/17 275). Among 10 742 women attempting to become pregnant, the prevalence of infertility was 25.0% (2680/10 742), which increased with age in the second population. Among women who failed to achieve pregnancy in the last 12 months, 3470 finished our questionnaire about fertility care, and 55.2% (1915/3470) of them had sought medical help. Sociodemographic risk factors for infertility included lower educational level [adjusted odds ratio (aOR) 3.4, 95% CI 2.0–5.5] and employment (aOR 2.3, 95% CI 1.9–2.9). Clinical risk factors were irregular menstrual cycle (aOR 1.8, 95% CI 1.2–2.5), light menstrual blood volume (aOR 1.6, 95% CI 1.2–2.0), history of cervicitis (aOR 1.5, 95% CI 1.2–2.0) and endometriosis (aOR 3.1, 95% CI 1.1–9.3), previous stillbirth (aOR 2.1, 95% CI 1.3–3.3) and miscarriage (aOR 2.7, 95% CI 2.1–3.5). In addition, history of operation was a significant risk factor of infertility.ConclusionsAmong couples of reproductive age in China, the prevalence of infertility was 25%, and almost half of the couples experiencing infertility had not sought medical help.Tweetable abstractIn China, 25% of couples actively attempting to become pregnant suffered infertility.