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BJOG. 2018 Mar;125(4):432-441. doi: 10.1111/1471-0528.14966. Epub 2017 Dec 28.

Epidemiology of infertility in China: a population-based study.

Zhou Z1,2,3, Zheng D1,2,3, Wu H1,2,3, Li R1,2,3, Xu S4, Kang Y5, Cao Y6, Chen X7, Zhu Y8, Xu S9, Chen ZJ10, Mol BW11,12, Qiao J1,2,3,13,14.

Author information

1
Department of Obstetrics and Gynaecology, Reproductive Medical Centre, Peking University Third Hospital, Beijing, China.
2
Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.
3
Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China.
4
Reproductive Medical Centre, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
5
Reproductive Medical Centre, Maternal and Children's Health Hospital of Fujian Province, Fuzhou, China.
6
Department of Obstetrics and Gynaecology, Reproductive Medical Centre, First Affiliated Hospital of Anhui Medical University, Hefei, China.
7
Reproductive Medical Centre, Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China.
8
Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
9
Population and Family Planning Research Institute of Heilongjiang Province, Harbin, China.
10
Centre for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.
11
The Robinson Research Institute, School of Medicine, University of Adelaide, Adelaide, SA, Australia.
12
The South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
13
Beijing Advanced Innovation Centre for Genomics, Beijing, China.
14
Peking-Tsinghua Centre for Life Sciences, Peking University, Beijing, China.

Abstract

OBJECTIVE:

To assess the current prevalence of and risk factors for infertility among couples of reproductive age in China.

DESIGN:

Population-based cross-sectional study.

SETTING:

We approached 25 270 couples in eight provinces/municipalities, of whom 18 571 (response rate 74%) were interviewed.

POPULATION:

Couples living together and married for more than 1 year, of whom the female spouse was 20-49 years old.

METHODS:

Women were approached via telephone and face-to-face conversation to complete the standardised and structured questionnaire by trained interviewers.

MAIN OUTCOME MEASURES:

Prevalence of and risk factors for infertility.

RESULTS:

Among 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.

CONCLUSIONS:

Among 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 ABSTRACT:

In China, 25% of couples actively attempting to become pregnant suffered infertility.

KEYWORDS:

Epidemiology; infertility; medical help; prevalence; risk factors

PMID:
29030908
DOI:
10.1111/1471-0528.14966
[Indexed for MEDLINE]
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