Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India.
Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India.
PLoS One. 2023 Jul 25;18(7):e0289096. doi: 10.1371/journal.pone.0289096. eCollection 2023.
The World Health Organisation (WHO) has recognised infertility as a public health issue. Although biological factors are considered to be the primary cause, factors like social, health, and lifestyle factors can all have an adverse effect on a couple's ability to reproduce. The study aimed to comprehend the infertility scenario in India and explore some of the potential causes. The study used standard demographic definitions and four rounds of the National Family Health Survey (NFHS) from 1992-1993 to 2015-16 to estimate the levels of primary and secondary infertility in India. Bivariate analysis, the t-test, and the Chi-square test were applied to capture significant changes in infertility over time. The multivariate logistic regression model was used to understand the extent of infertility among Indian couples from various socioeconomic groups, lifestyle levels, and reproductive behaviour in 2015-16. Primary infertility declined steadily from 1992 to 2015, whereas secondary infertility increased from 19.5% in 1992-93 to 28.6% in 2015-16. This trend is related to declining fertility rates, particularly in India's southern states. Age at marriage, biological factors, and lifestyle factors were all strongly linked to infertility. People with higher education levels and late marriages were more likely to experience primary infertility. Alcohol consumption, smoking, obesity, and noncommunicable disease are all strongly linked to secondary infertility. Our study has policy implications, and we draw attention to alarming infertility in India, which has gone unnoticed due to large population. We suggests enhancing the current health and reproductive programmes, educating people about improving their lifestyle choices and sexual behaviour, and calling attention to a significant shift in fertility dynamics.
世界卫生组织(WHO)已经将不孕不育视为公共卫生问题。虽然生物因素被认为是主要原因,但社会、健康和生活方式等因素都会对夫妻的生育能力产生不利影响。本研究旨在了解印度的不孕不育情况,并探讨一些潜在的原因。该研究使用了标准的人口统计定义和 1992-1993 年至 2015-16 年四轮全国家庭健康调查(NFHS)的数据来估计印度原发性和继发性不孕的水平。应用了双变量分析、t 检验和卡方检验来捕捉不孕不育随时间的显著变化。使用多变量逻辑回归模型来了解 2015-16 年印度不同社会经济群体、生活方式水平和生殖行为的夫妇中不孕不育的程度。原发性不孕从 1992 年到 2015 年持续下降,而继发性不孕从 1992-93 年的 19.5%增加到 2015-16 年的 28.6%。这一趋势与生育率的下降有关,尤其是在印度南部各州。初婚年龄、生物因素和生活方式因素都与不孕不育密切相关。文化程度较高和晚婚的人更容易出现原发性不孕。饮酒、吸烟、肥胖和非传染性疾病都与继发性不孕密切相关。我们的研究具有政策意义,我们提请注意印度令人震惊的不孕不育现象,由于人口众多,这一现象一直没有引起人们的注意。我们建议加强当前的健康和生殖计划,教育人们改善生活方式选择和性行为,并关注生育动态的重大转变。