Infertility Continues 40-Plus-Year Decline Among US Women

Joe Barber Jr, PhD

August 14, 2013

Infertility rates decreased significantly among US women between 1982 and 2010, according to the findings of the National Survey of Family Growth (NSFG).The results continue a downward national trend for female infertility or impaired fecundity from a high of 11.2% of married women aged 15 to 44 years in 1965 to 6% between 2006 and 2010.

Anjani Chandra, PhD, from the National Center for Health Statistics, Hyattsville, Maryland, and colleagues present their findings in a report published online August 14 in National Health Statistics Reports.

In the study, the researchers used data from the NSFG, which was conducted from June 2006 to June 2010, to assess rates of infertility and impaired fecundity in US adults. They compared those data with past NSFG data.

The surveys indicate that the percentage of married women between 15 and 44 years of age who were infertile, defined as an inability to become pregnant for at least 12 months despite having unprotected sex with the same husband or partner in each of those months, declined from 8.5% in 1982 to 6.0% in 2010.

Conversely, impaired fecundity, defined as physical difficulty in becoming pregnant or carrying a pregnancy to live birth, increased from 10.8% in 1982 to 12.9% in 1995, and peaking at 15.1% in 2002 before falling to 12.1% in 2006-2010.

Age appears to be a factor in infertility for women. The investigators found that 7.0% of women between 15 and 24 years of age had impaired fecundity compared with 13% of women aged 25 to 44 years. Among nulliparous women, 14% of the women aged 25 to 29 years were infertile or subfertile, whereas 30% of those aged 40 to 44 years were.

Infertility did not appear to be associated with education or income level, although a higher education level and greater income appeared to be linked with lower levels of surgical infertility. (Presumed fecund included those individuals who did not fit into the subfertile, surgically sterile, or nonsurgically sterile groups.)

In addition, 63.9% of women with at least a Master's degree were presumed fecund compared with 35.3% of women with no high school diploma or equivalent.

A greater percentage of Asian women (74.6%) were presumed to be fertile compared with other ethnicities (49.1% - 52.6%).

In multivariate analysis adjusted for demographic variables such as income and education, an age of 40 to 44 years among nulliparous women was significantly associated with both impaired fecundity (odds ratio [OR], 3.48; 95% confidence interval [CI], 2.26 - 5.36) and 12-month infertility (OR, 12.61; 95% CI, 6.19 - 25.71) compared with parous women age of 22 to 29 years.

Regarding fertility intentions, 59% of nulliparous women with impaired fecundity intended to have children compared with 39% of parous women. In addition, 64% of married nulliparous women with 12-month infertility planned to conceive vs 53% of parous, married infertile women.

Among men aged 15 to 44 years, fertility rates were similar between 2002 (73.8%) and 2006-2010 (76.7%). However, infertility, particularly surgical sterilization, was more common among men aged 40 to 44 years than among their younger counterparts.

The authors have disclosed no relevant financial relationships.

National Health Stat Rep. Published online August 14, 2013. Full text


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