News | U.S. female infertility rates largely stable over 25 years, with greater impact on disadvantaged groups
Despite social and reproductive changes, female infertility rates in the United States showed no significant overall shift for nearly a quarter-century. A Johns Hopkins University School of Medicine study in Fertility and Sterility found minor annual fluctuations from 1995 to 2019 but similar overall levels.
Researchers analyzed 53,764 women in the National Survey of Family Growth (NSFG). Infertility prevalence was 5.8% in 2006–2010 and 8.1% in 2017–2019. The differences were not statistically significant, indicating rates remained broadly stable over 25 years.
Infertility was more common among older women, non-Hispanic Black women, those with less education or income, and those lacking sexual and reproductive healthcare.
“To meet national public-health goals for reducing infertility, we must continue investing in public healthcare and equitable access to sexual and reproductive health services.”
—Morgan Snow, first author and Johns Hopkins medical student
Rising STIs and declining preventive gynecologic care may affect fertility
Infertility is defined as not conceiving after one year of regular unprotected sex and affects millions of reproductive-age women and men worldwide.
Senior author Maria Trent, Bloomberg Professor of American Health and a pediatric specialist, said rising sexually transmitted infection (STI) rates, declining preventive gynecologic care, and older age at first birth may influence infertility.
“We are in a distinctive period of rising STIs and threatened healthcare access. Clinicians caring for women need to understand how these changes affect fertility.”
—Maria Trent, MD, senior author, Johns Hopkins University
The NSFG did not ask directly about infertility. Researchers modeled it from sexual activity, contraceptive use, pregnancy history, and other variables. Race, education, income, healthcare, and other sociodemographic data provided a broader profile.
Higher-risk groups: age, education, race, and lack of care
Risk was significantly above average among:
Women aged 40–44, who were 11 times as likely to experience infertility as younger women;
Women without a high-school education, whose risk was twice that of more educated women;
Non-Hispanic Black women, whose rate was 44% higher than other groups;
Women without recent sexual-health services, whose rate was 61% higher.
Unlike earlier research, this analysis did not find higher infertility among Hispanic women, possibly because of differences in assessment methods.
“These numbers remind us that infertility remains a problem, particularly for disadvantaged groups,” Trent said. “We must identify high-risk populations to support more targeted public-health interventions.”
Expanding sexual-health services, particularly testing and treatment for chlamydia and gonorrhea, may reduce pelvic inflammatory disease and infection-related infertility.
Study limitations and next steps
The NSFG was not designed specifically to study infertility, so estimates should be interpreted cautiously and compared with other research.
“Nevertheless, our study provides an important long-term perspective on infertility in the United States, particularly its associations with race, education, and healthcare.”
—Morgan Snow
Co-authors included Jamie Perin, Ph.D., of Johns Hopkins, and Tyler Vranich, M.S., a former Johns Hopkins student now at the Medical University of South Carolina. The National Institute of Nursing Research funded the study under grant NINR-R01NR013507 (Trent).
News | U.S. female infertility rates largely stable over 25 years, with greater impact on disadvantaged groups
News | U.S. female infertility rates largely stable over 25 years, with greater impact on disadvantaged groups
Despite social and reproductive changes, female infertility rates in the United States showed no significant overall shift for nearly a quarter-century. A Johns Hopkins University School of Medicine study in Fertility and Sterility found minor annual fluctuations from 1995 to 2019 but similar overall levels.
Researchers analyzed 53,764 women in the National Survey of Family Growth (NSFG). Infertility prevalence was 5.8% in 2006–2010 and 8.1% in 2017–2019. The differences were not statistically significant, indicating rates remained broadly stable over 25 years.
Infertility was more common among older women, non-Hispanic Black women, those with less education or income, and those lacking sexual and reproductive healthcare.
“To meet national public-health goals for reducing infertility, we must continue investing in public healthcare and equitable access to sexual and reproductive health services.”
—Morgan Snow, first author and Johns Hopkins medical student
Rising STIs and declining preventive gynecologic care may affect fertility
Infertility is defined as not conceiving after one year of regular unprotected sex and affects millions of reproductive-age women and men worldwide.
Senior author Maria Trent, Bloomberg Professor of American Health and a pediatric specialist, said rising sexually transmitted infection (STI) rates, declining preventive gynecologic care, and older age at first birth may influence infertility.
“We are in a distinctive period of rising STIs and threatened healthcare access. Clinicians caring for women need to understand how these changes affect fertility.”
—Maria Trent, MD, senior author, Johns Hopkins University
The NSFG did not ask directly about infertility. Researchers modeled it from sexual activity, contraceptive use, pregnancy history, and other variables. Race, education, income, healthcare, and other sociodemographic data provided a broader profile.
Higher-risk groups: age, education, race, and lack of care
Risk was significantly above average among:
Women aged 40–44, who were 11 times as likely to experience infertility as younger women;
Women without a high-school education, whose risk was twice that of more educated women;
Non-Hispanic Black women, whose rate was 44% higher than other groups;
Women without recent sexual-health services, whose rate was 61% higher.
Unlike earlier research, this analysis did not find higher infertility among Hispanic women, possibly because of differences in assessment methods.
“These numbers remind us that infertility remains a problem, particularly for disadvantaged groups,” Trent said. “We must identify high-risk populations to support more targeted public-health interventions.”
Expanding sexual-health services, particularly testing and treatment for chlamydia and gonorrhea, may reduce pelvic inflammatory disease and infection-related infertility.
Study limitations and next steps
The NSFG was not designed specifically to study infertility, so estimates should be interpreted cautiously and compared with other research.
“Nevertheless, our study provides an important long-term perspective on infertility in the United States, particularly its associations with race, education, and healthcare.”
—Morgan Snow
Co-authors included Jamie Perin, Ph.D., of Johns Hopkins, and Tyler Vranich, M.S., a former Johns Hopkins student now at the Medical University of South Carolina. The National Institute of Nursing Research funded the study under grant NINR-R01NR013507 (Trent).
Source:
Collected online