The global rate of infertility has not significantly changed over the past 2 decades, with the exception of regions in sub-Saharan Africa and South Asia, a study shows.
Gretchen Stevens (World Health Organization, Geneva, Switzerland) and team found that global levels of infertility were similar in 1990 and 2010, with only a slight overall decrease of 0.1% in primary infertility - due mostly to a more pronounced drop in sub-Saharan Africa and South Asia - and a small 0.4% increase in secondary infertility.
The decline in primary infertility was greatest in sub-Saharan Africa, dropping from 2.7% in 1990 to 1.9% in 2010. This reflects a decrease of 0.8 percentage points over the 20-year period.
Meanwhile, in South Asia the prevalence of primary infertility declined by 0.6 percentage points, making it, together with sub-Saharan Africa, one of the two countries with the highest prevalence of primary infertility in 1990. In 2010, South Asia and sub-Saharan Africa ranked 2nd and 4th, respectively, for global infertility.
The analysis of 277 national surveys revealed that 1.9% of 20-44-year-old women experienced primary infertility in 2010 while 10.5% experienced secondary infertility - corresponding to a total of 48.5 million couples.
Although in most regions there were no statistically significant changes in the prevalence of infertility among women who were exposed to risk for pregnancy, reduced child-seeking behavior (defined as reduced exposure to pregnancy due to changing fertility preferences) resulted in a reduction in primary infertility among all women, from 1.6% in 1990 to 1.5% in 2012, and a reduction of secondary infertility among all women from 3.9% to 3.0%
The absolute number of couples affected by infertility increased from 42.0 million in 1990 to 48.5 million in 2010, after taking population growth into account.
The authors found that, with a few exceptions, global and country patterns of secondary infertility were similar to those of primary infertility.
"Independent from population growth and worldwide declines in the preferred number of children, we found little evidence of changes in infertility over two decades, apart from in the regions of Sub-Saharan Africa and South Asia," write Stevens and team in PLoS Medicine.
"In the absence of widespread data collection on time to pregnancy, the methods used and results presented here provide valuable insights into global, regional, and country patterns and trends in infertility."
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