Global, regional, and national burden of infertility attributable to PCOS, 1990-2019.
Level 4 - case-series / case-control
Cross-sectional and ecological epidemiological modeling study using GBD 2019 secondary data
PubMed 38011904 · doi:10.1093/humrep/dead241
What was done
Using data from the Global Burden of Diseases 2019 study, researchers analyzed the prevalence and years lived with disability (YLD) of female infertility attributable to polycystic ovary syndrome (PCOS) among reproductive-aged women (15–49 years) across 204 countries and territories in 21 regions from 1990 to 2019. Metrics included raw case counts, age-standardized rates per 100,000 persons, and average annual percentage changes (AAPCs), stratified by age and Socio-demographic Index (SDI).
What was found
Globally, prevalent cases of infertility attributable to PCOS doubled from 6.00 million in 1990 to 12.13 million in 2019. The age-standardized prevalence rate (ASPR) increased from 223.50 to 308.25 per 100,000 persons, and global YLDs rose 98.0% from 35.20 thousand to 69.70 thousand. Burden was significantly higher in high-SDI regions than in other tiers, with positive associations between burden estimates and SDI (all P < 0.001). The largest annual increases in ASPR and age-standardized YLD rates occurred in middle SDI (AAPC 1.96 [95% CI: 1.87–2.06] and 1.94 [95% CI: 1.87–2.00]) and low-middle SDI regions (AAPC 1.96 [95% CI: 1.90–2.03] and 1.90 [95% CI: 1.85–1.94]). By region and country, High-income Asia Pacific and Italy had the highest ASPR and age-standardized YLD rates.
Why it matters
This analysis establishes multi-decade global trends in PCOS-related infertility, highlighting a doubling case burden and rapid growth across middle-SDI nations to guide reproductive health resource allocation.
Limits
The findings depend on secondary GBD 2019 modeling, which is constrained by sparse primary data in low-resource countries and detection bias favoring nations with established medical infrastructure. Changes in diagnostic criteria over time may introduce classification bias, and data were unavailable to distinguish specific PCOS phenotypes.
Cited by
- supports PCOS is the number one cause of anovulatory infertility globally.