Global, regional, and national burden and trend of infertility and its subtypes from 1990 to 2021, with projections to 2035.

PURPOSE

To study the global, regional and national burden and trend of primary and secondary infertility, by sex and sociodemographic index (SDI), over the period 1990-2021.

METHODS

Data on the prevalence and disability-adjusted life years (DALYs) due to infertility and its subtypes were retrieved from the GBD study 2021 for 204 countries and territories from 1990 to 2021. The counts and age-standardized rates are presented, along with their corresponding 95% uncertainty intervals (UIs). Estimated annual percentage changes (EAPCs) were computed using linear regression analysis. Decomposition analysis was conducted to determine the effects of population growth, aging, and epidemiological shifts on disease burden. Frontier analysis was performed to identify potential improvement areas and disparities among countries by development status. Bayesian age-period-cohort analysis (BAPC) predicted global lung cancer mortality from 2020 to 2035.

RESULTS

Globally, the age-standardized prevalence rate (ASPR) of infertility changed from 4071.04 (95% UI: 2660.05, 6223.25) per 100,000 in 1990 to 5030.42 (3207.13, 7918.99) per 100,000 in 2021, with the EAPC being 0.65. The age-standardized DALYs rate (ASDR) changed from 23.15 (8.91, 53.73) per 100,000 in 1990 to 28.54 (11.05, 67.94) per 100,000 in 2021, with the EAPC being 0.52. It is anticipated that the ASPR exhibits a downward trend for overall primary infertility, whereas they are expected to show an upward trend for overall secondary infertility by 2035, in comparison with 2021.

CONCLUSIONS

Governments and the public should recognize the magnitude of the issue of infertility and prioritize implementing targeted interventions and strategies to improve reproductive health worldwide.