News | Global burden of female infertility rises sharply, with women aged 35–39 at greatest risk
A global analysis found that the prevalence of female infertility has risen significantly over the past three decades. Women in their thirties, in particular, face the greatest risk worldwide.
Published recently in Scientific Reports, the study analyzed female infertility trends across regions and age groups from 1990 to 2021 and incorporated future projections, revealing a growing global burden.
By 2021, approximately 110 million women worldwide were affected by infertility, an 84% increase from 1990. Women aged 35–39 were the most affected group and had a significantly higher risk.
Definition and background of female infertility
The World Health Organization (WHO) defines female infertility as inability to achieve pregnancy after 12 months of regular unprotected intercourse. This study, however, used Global Burden of Disease (GBD) 2021 data, which apply a different definition: primary infertility means no pregnancy after five years of unprotected intercourse, while secondary infertility means that a couple wishing to have a child has not achieved pregnancy in the past five years without contraception.
About one in seven couples in developed countries experience infertility, compared with up to 25% in developing countries. In China, about 15% of women of reproductive age are affected.
Although assisted reproductive treatments such as IVF offer options, their high cost remains a major burden for many families. A cycle costs more than US$12,000 in the United States and about US$4,000 in Japan, measured in 2006 dollars.
Findings and trends
Using the GBD database, the study analyzed age- and region-specific prevalence from 1990 to 2021 and projected trends beyond 2050. The database compiles household surveys, demographic records, and other reliable national sources.
In 2021, the global age-standardized prevalence rate (ASPR) of female infertility was 1,367.4 per 100,000, with 601,000 infertility-related disability-adjusted life years (DALYs). The burden was highest among women aged 35–39, whose ASPR was 1.2 times that of women aged 30–34.
Asia, particularly China and India, recorded the largest absolute burden. East Asia had the highest ASPR, while Australia and New Zealand reported the lowest prevalence.
Since 2010, infertility rates have risen sharply in low- and lower-middle-income regions, while high-income regions saw a slow increase followed by a slight decline.
Main conclusions and outlook
The study concluded that female infertility is an important global health issue affecting more than 9% of women of reproductive age, with prevalence and burden rising significantly since 1990. Delayed childbearing, urbanization, industrial pollution, and possible epigenetic changes may contribute to this trend.
Although the absolute number of cases and DALYs is projected to decline by 2050, ASPR is expected to continue rising because of population aging, lifestyle changes, environmental pollution, and other factors. Regional differences, particularly the upward trend in Andean Latin America and improvement in Oceania, highlight the need for targeted, region-specific interventions.
The researchers noted that even if overall case numbers decline, infertility remains a worsening global issue requiring stronger prevention, earlier screening, and improved reproductive-health policy.
News | Global burden of female infertility rises sharply, with women aged 35–39 at greatest risk
News | Global burden of female infertility rises sharply, with women aged 35–39 at greatest risk
A global analysis found that the prevalence of female infertility has risen significantly over the past three decades. Women in their thirties, in particular, face the greatest risk worldwide.
Published recently in Scientific Reports, the study analyzed female infertility trends across regions and age groups from 1990 to 2021 and incorporated future projections, revealing a growing global burden.
By 2021, approximately 110 million women worldwide were affected by infertility, an 84% increase from 1990. Women aged 35–39 were the most affected group and had a significantly higher risk.
Definition and background of female infertility
The World Health Organization (WHO) defines female infertility as inability to achieve pregnancy after 12 months of regular unprotected intercourse. This study, however, used Global Burden of Disease (GBD) 2021 data, which apply a different definition: primary infertility means no pregnancy after five years of unprotected intercourse, while secondary infertility means that a couple wishing to have a child has not achieved pregnancy in the past five years without contraception.
About one in seven couples in developed countries experience infertility, compared with up to 25% in developing countries. In China, about 15% of women of reproductive age are affected.
Although assisted reproductive treatments such as IVF offer options, their high cost remains a major burden for many families. A cycle costs more than US$12,000 in the United States and about US$4,000 in Japan, measured in 2006 dollars.
Findings and trends
Using the GBD database, the study analyzed age- and region-specific prevalence from 1990 to 2021 and projected trends beyond 2050. The database compiles household surveys, demographic records, and other reliable national sources.
In 2021, the global age-standardized prevalence rate (ASPR) of female infertility was 1,367.4 per 100,000, with 601,000 infertility-related disability-adjusted life years (DALYs). The burden was highest among women aged 35–39, whose ASPR was 1.2 times that of women aged 30–34.
Asia, particularly China and India, recorded the largest absolute burden. East Asia had the highest ASPR, while Australia and New Zealand reported the lowest prevalence.
Since 2010, infertility rates have risen sharply in low- and lower-middle-income regions, while high-income regions saw a slow increase followed by a slight decline.
Main conclusions and outlook
The study concluded that female infertility is an important global health issue affecting more than 9% of women of reproductive age, with prevalence and burden rising significantly since 1990. Delayed childbearing, urbanization, industrial pollution, and possible epigenetic changes may contribute to this trend.
Although the absolute number of cases and DALYs is projected to decline by 2050, ASPR is expected to continue rising because of population aging, lifestyle changes, environmental pollution, and other factors. Regional differences, particularly the upward trend in Andean Latin America and improvement in Oceania, highlight the need for targeted, region-specific interventions.
The researchers noted that even if overall case numbers decline, infertility remains a worsening global issue requiring stronger prevention, earlier screening, and improved reproductive-health policy.
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