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Liang S, Chen Y, Wang Q, et al. Prevalence and associated factors of infertility among 20-49 year old women in Henan Province, China. Reprod Health. 2021;18(1):254doi: 10.1186/s12978-021-01298-2.
Liang, S., Chen, Y., Wang, Q., Chen, H., Cui, C., Xu, X., Zhang, Q., & Zhang, C. (2021). Prevalence and associated factors of infertility among 20-49 year old women in Henan Province, China. Reproductive health, 18(1), 254. https://doi.org/10.1186/s12978-021-01298-2
Liang, Shoujing, et al. "Prevalence and associated factors of infertility among 20-49 year old women in Henan Province, China." Reproductive health vol. 18,1 (2021): 254. doi: https://doi.org/10.1186/s12978-021-01298-2
Liang S, Chen Y, Wang Q, Chen H, Cui C, Xu X, Zhang Q, Zhang C. Prevalence and associated factors of infertility among 20-49 year old women in Henan Province, China. Reprod Health. 2021 Dec 20;18(1):254. doi: 10.1186/s12978-021-01298-2. PMID: 34930324.
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Reprod Health. 2021 Dec 20;18(1):254. doi: 10.1186/s12978-021-01298-2.

Prevalence and associated factors of infertility among 20-49 year old women in Henan Province, China.

Reproductive health

Shoujing Liang, Yuanhui Chen, Qian Wang, Huanhuan Chen, Chenchen Cui, Xiaohang Xu, Qingwen Zhang, Cuilian Zhang

Affiliations

  1. Department of Reproductive Medicine Center, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, No. 7 Weiwu Road, Zhengzhou, Henan Province, China.
  2. Department of Reproductive Medicine Center, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, No. 7 Weiwu Road, Zhengzhou, Henan Province, China. [email protected].

PMID: 34930324 DOI: 10.1186/s12978-021-01298-2

Abstract

BACKGROUND: Infertility is a reproductive health problem which affects not only individuals, families and social populations. Recently, the infertility rate in China has a trend of increase year by year, and few studies have reported the infertility rate in Henan Province, China. The aim of this study was to investigate the current prevalence and associated factors of infertility among women of childbearing age in Henan Province, China.

METHODS: This cross-sectional study was conducted from March 2019 to October 2019. We sampled 765 women who were 20-49 years old in eight hospitals of four cities in Henan Province, China. This survey included a questionnaire, physical examination, vaginal ultrasound examinations, and serum anti-Mullerian hormone (AMH) assessment, all of which were conducted under uniform standards by trained personnel. According to the data collected from questionnaire, participants were divided into infertile and fertile groups and analyzed associated factors.

RESULTS: Among all the 765 participants in this study, the prevalence of infertility was 24.58%. The prevalence of primary infertility was 6.54%, and the prevalence of secondary infertility was 18.04%. In logistic multivariate regression analyses, infertility was associated with age (p < 0.001), history of gynecological surgery (p < 0.001), sweet food (p = 0.003) and decreased ovarian reserve (DOR) (p < 0.001). After further analyses, factors associated with primary infertility were age of marriage (p = 0.006), age of first sexual intercourse (p = 0.003), long-term air-conditioning environment (p < 0.001), decreased ovarian reserve (p = 0.005) and age (p = 0.002). And factors associated with secondary infertility were history of gynecological surgery (p < 0.001), decreased ovarian reserve (p = 0.002), waist-to-hip ratio (WHR) above 0.85 (p = 0.043), delivery times (p = 0.001) and ages (p < 0.001).

CONCLUSION: The prevalence of infertility among women aged 20-49 was 24.58% and only 61.17% infertile women sought medical help in Henan Province, China. Age, history of gynecological surgeries and DOR may increase the risk of infertility. Local public health departments and medical professionals need to discharge their duty of reducing the high incidence of infertility and protecting women's reproductive health.

© 2021. The Author(s).

Keywords: Epidemiology; Infertility; Prevalence; Reproduction; Risk factors

References

  1. Sun H, Gong T-T, Jiang Y-T, Zhang S, Zhao Y-H, Wu Q-J. Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990–2017: results from a global burden of disease study, 2017. Aging. 2019;11(3):10952–91. - PubMed
  2. Hart RJ. Physiological aspects of female fertility: role of the environment, modern lifestyle, and genetics. Physiol Rev. 2016;96(3):873–909. - PubMed
  3. van Roode T, Dickson NP, Righarts AA, Gillett WR. Cumulative incidence of infertility in a New Zealand birth cohort to age 38 by sex and the relationship with family formation. Fertil Steril. 2015;103(4):1053-1058.e2. - PubMed
  4. Checa Vizcaíno MA, González-Comadran M, Jacquemin B. Outdoor air pollution and human infertility: a systematic review. Fertil Steril. 2016;106(4):897-904.e1. - PubMed
  5. Petraglia F, Serour GI, Chapron C. The changing prevalence of infertility. Int J Gynaecol Obstet. 2013;123:S4-8. - PubMed
  6. Malina A, Suwalska-Barancewicz D. Comparison of early-stage mothers and childless women seeking pregnancy: experienced stress, resilience and satisfaction with relationship with the partner. Int J Environ Res Public Health. 2021;18(5):2543. - PubMed
  7. Boivin J, Bunting L, Collins JA, Nygren KG. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Hum Reprod. 2007;22(6):1506–12. - PubMed
  8. Liu J, Larsen U, Wyshak G. Prevalence of primary infertility in China: in-depth analysis of infertility differentials in three minority province/autonomous regions. J Biosoc Sci. 2005;37(1):55–74. - PubMed
  9. Che Y, Cleland J. Infertility in Shanghai: prevalence, treatment seeking and impact. J Obstet Gynaecol. 2002;22(6):643–8. - PubMed
  10. Zhou Z, Zheng D, Wu H, Li R, Xu S, Kang Y, et al. Epidemiology of infertility in China: a population-based study. BJOG. 2018;125(4):432–41. - PubMed
  11. Cong J, Li P, Zheng L, Tan J. Prevalence and risk factors of infertility at a rural site of Northern China. PLoS ONE. 2016;11(5):e0155563. - PubMed
  12. Chen J, Zhong C, Liang H, Yang Y, Zhang O, Gao E, et al. The relationship between age at menarche and infertility among Chinese rural women. Eur J Obstet Gynecol Reprod Biol. 2015;194:68–72. - PubMed
  13. Meng Q, Ren A, Zhang L, Liu J, Li Z, Yang Y, et al. Incidence of infertility and risk factors of impaired fecundity among newly married couples in a Chinese population. Reprod Biomed Online. 2015;30(1):92–100. - PubMed
  14. He Y, Zheng D, Shang W, Wang X, Zhao S, Wei Z, et al. Prevalence of oligomenorrhea among women of childbearing age in China: a large community-based study. Womens Health (Lond). 2020;16:1745506520928617. - PubMed
  15. Farquhar CM, Bhattacharya S, Repping S, Mastenbroek S, Kamath MS, Marjoribanks J, et al. Female subfertility. Nat Rev Dis Primers. 2019;5(1):7. - PubMed
  16. Cohen SA, Richards CL. The Cairo consensus: population, development and women. Fam Plann Perspect. 1994;26(6):272. - PubMed
  17. Strategy to Accelerate Progress towards the Attainment of International Development Goals and Targets Related to Reproductive Health. Reprod Health Matters. 2005;13(25):11–8. - PubMed
  18. Inhorn MC. Right to assisted reproductive technology: overcoming infertility in low-resource countries. Int J Gynecol Obstet. 2009;106(2):172–4. - PubMed
  19. Bai F, Wang DY, Fan YJ, Qiu J, Wang L, Dai Y, et al. Assisted reproductive technology service availability, efficacy and safety in mainland China: 2016. Hum Reprod. 2020;35(2):446–52. - PubMed
  20. Hu L, Bu Z, Huang G, Sun H, Deng C, Sun Y. Assisted reproductive technology in China: results generated from data reporting system by CSRM from 2013 to 2016. Front Endocrinol (Lausanne). 2020;11:458. - PubMed
  21. Vander Borght M, Wyns C. Fertility and infertility: definition and epidemiology. Clin Biochem. 2018;62:2–10. - PubMed
  22. Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril. 2009;92(5):1520–4. - PubMed
  23. Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, de Mouzon J, Sokol R, et al. The international glossary on infertility and fertility care, 2017. Fertil Steril. 2017;108(3):393–406. - PubMed
  24. The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary SYNDROME (PCOS). Hum Reprod. 2004;19(1):41–7. - PubMed
  25. Thoma ME, mclain AC, Louis JF, King RB, Trumble AC, Sundaram R, et al. Prevalence of infertility in the United States as estimated by the current duration approach and a traditional constructed approach. Fertil Steril. 2013;99(5):1324-1331.e1. - PubMed
  26. Bushnik T, Cook JL, Yuzpe AA, Tough S, Collins J. Estimating the prevalence of infertility in Canada. Hum Reprod. 2012;27(3):738–46. - PubMed
  27. Datta J, Palmer MJ, Tanton C, Gibson LJ, Jones KG, Macdowall W, et al. Prevalence of infertility and help seeking among 15 000 women and men. Hum Reprod. 2016;31(9):2108–18. - PubMed
  28. Sarac M, Koc I. Prevalence and risk factors of infertility in Turkey: evidence from demographic and health surveys, 1993–2013. J Biosoc Sci. 2018;50(4):472–90. - PubMed
  29. Kazemijaliseh H, Ramezani Tehrani F, Behboudi-Gandevani S, Hosseinpanah F, Khalili D, Azizi F. The prevalence and causes of primary infertility in Iran: a population-based study. Glob J Health Sci. 2015;7(6):226–32. - PubMed
  30. Kumar D. Prevalence of female infertility and its socio-economic factors in tribal communities of Central India. Rural Remote Health. 2007;7(2):456. - PubMed
  31. Polis CB, Cox CM, Tunçalp Ö, McLain AC, Thoma ME. Estimating infertility prevalence in low-to-middle-income countries: an application of a current duration approach to Demographic and Health Survey data. Hum Reprod. 2017;32(5):1064–74. - PubMed
  32. Dick M-LB, Bain CJ, Purdie DM, Siskind V, Molloy D, Green AC. Self-reported difficulty in conceiving as a measure of infertility. Hum Reprod. 2003;18(12):2711–7. - PubMed
  33. Li R, Zhang Q, Yang D, Li S, Lu S, Wu X, et al. Prevalence of polycystic ovary syndrome in women in China: a large community-based study. Hum Reprod. 2013;28(9):2562–9. - PubMed
  34. Zhuang J, Liu Y, Xu L, Liu X, Zhou L, Tang L, et al. Prevalence of the polycystic ovary syndrome in female residents of Chengdu. China Gynecol Obstet Invest. 2014;77(4):217–23. - PubMed
  35. Hart R. PCOS and infertility. Panminerva Med. 2008;50(4):305–14. - PubMed
  36. Moolhuijsen LME, Visser JA. Anti-Müllerian hormone and ovarian reserve: update on assessing ovarian function. J Clin Endocrinol Metab. 2020;105(11):3361–73. - PubMed
  37. Broer SL, Broekmans FJM, Laven JSE, Fauser BCJM. Anti-Müllerian hormone: ovarian reserve testing and its potential clinical implications. Hum Reprod Update. 2014;20(5):688–701. - PubMed
  38. Du X, Ding T, Zhang H, Zhang C, Ma W, Zhong Y, et al. Age-specific normal reference range for serum anti-müllerian hormone in healthy Chinese Han women: a nationwide population-based study. Reprod Sci. 2016;23(8):1019–27. - PubMed
  39. American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and Practice Committee. Female age-related fertility decline. Committee Opinion No. 589. Fertil Steril. 2014;101(3):633–4. - PubMed
  40. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril. 2015;103(3):e9–17. - PubMed
  41. Alborzi S, Madadi G, Samsami A, Soheil P, Azizi M, Alborzi M, et al. Decreased ovarian reserve: any new hope? Minerva Ginecol. 2015;67(2):149–67. - PubMed
  42. Henes M, Engler T, Taran F-A, Brucker S, Rall K, Janz B, et al. Ovarian cyst removal influences ovarian reserve dependent on histology, size and type of operation. Womens Health (Lond). 2018;14:1745506518778992. - PubMed
  43. Kasum M. Fertility following myomectomy. Acta Clin Croat. 2009;48(2):137–43. - PubMed
  44. Pasquali R. Obesity, fat distribution and infertility. Maturitas. 2006;54(4):363–71. - PubMed
  45. Loy SL, Cheung YB, Soh SE, Ng S, Tint MT, Aris IM, et al. Female adiposity and time-to-pregnancy: a multiethnic prospective cohort. Hum Reprod. 2018;33(11):2141–9. - PubMed
  46. Gambineri A, Laudisio D, Marocco C, Radellini S, Colao A, et al. Female infertility: which role for obesity? Int J Obes Suppl. 2019;9(1):65–72. - PubMed
  47. Kannan S, Bhaskaran RS. Sustained obesity reduces litter size by decreasing proteins regulating folliculogenesis and ovulation in rats—a cafeteria diet model. Biochem Biophys Res Commun. 2019;519(3):475–80. - PubMed
  48. Espinós JJ, Polo A, Sánchez-Hernández J, Bordas R, Pares P, Martínez O, et al. Weight decrease improves live birth rates in obese women undergoing IVF: a pilot study. Reprod Biomed Online. 2017;35(4):417–24. - PubMed
  49. Konstantinidou F, Stuppia L, Gatta V. Looking inside the world of granulosa cells: the noxious effects of cigarette smoke. Biomedicines. 2020;8(9):309. - PubMed
  50. Lyngsø J, Kesmodel US, Bay B, Ingerslev HJ, Pisinger CH, Ramlau-Hansen CH. Female cigarette smoking and successful fertility treatment: a Danish cohort study. Acta Obstet Gynecol Scand. 2021;100(1):58–66. - PubMed

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