PPubMed12 Nov 2022Cited 430×

Infertility prevalence and the methods of estimation from 1990 to 2021: a systematic review and meta-analysis

C M Cox, M E Thoma, N Tchangalova, G Mburu, M J Bornstein, C L Johnson, J Kiarie

Abstract

Accounting for aspects and sources of heterogeneity, we generated pooled estimates of period and lifetime prevalence of 12-month infertility globally and by region, methodological approach and respondent type with the best available data. Additionally, our study enables further insight on components that could be addressed in future infertility prevalence research. As such, we propose several recommendations to improve infertility prevalence estimates and our ability to compare these estimates across settings and time ([hoac051-F7]). Valid and reliable estimates of infertility are needed to un

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Pooled estimates of lifetime and period prevalence of 12-month infertility were 17.5% and 12.6%, respectively, but varied by study population and methodological approach.

What’s new

i.Conducted a systematic review and meta‑analysis of infertility prevalence studies published between 1990 and 2021.
ii.Identified and classified five methodological approaches for measuring infertility prevalence.
iii.Provided pooled global estimates of lifetime (17.5%) and period (12.6%) 12‑month infertility prevalence with regional breakdowns.
iv.Performed multivariable meta‑regression to assess the impact of region and methodological approach on prevalence estimates.
v.Issued recommendations to improve future infertility prevalence measurement and reporting.

How they did it

The authors searched six electronic databases, organization websites, and conference proceedings for studies published from 1 January 1990 to 11 March 2021, then screened titles, abstracts, and full texts in duplicate. Data were extracted by one reviewer and checked by a second, and random‑effects meta‑analysis with meta‑regression was used to generate pooled prevalence estimates and assess methodological heterogeneity.

What they found

Pooled lifetime prevalence of 12‑month infertility: 17.5% (95% CI 15.0–20.3).
Pooled period prevalence of 12‑month infertility: 12.6% (95% CI 10.7–14.6).
Primary 12‑month infertility lifetime prevalence: 9.6% (95% CI 6.3–14.3).
Primary 12‑month infertility period prevalence: 9.0% (95% CI 6.6–12.2).
Secondary 12‑month infertility lifetime prevalence: 6.5% (95% CI 3.9–10.7).

Caveats

✕Excludes social infertility and conditional childlessness, limiting the scope of estimates.
✕Inclusion of clinic‑based studies may not represent the general population in all contexts.
✕Focuses only on biological‑based infertility, omitting other relevant forms.
✕High heterogeneity (I² ≈ 99%) across studies may affect the precision of pooled estimates.

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