Global, Regional, and National Burden of Endometriosis, PCOS, and Unexplained Infertility and Their Attribution to Infertility, 1990-2021: Global Burden of Disease Study 2021.
Level 3 - non-randomized controlled study
Global epidemiological surveillance and population modeling analysis (by design analogy, not clinical CEBM)
PubMed 41437663 · doi:10.1111/jebm.70100
What was done
Using data from the Global Burden of Disease Study 2021 (1990–2021), the authors assessed temporal trends in age-standardized prevalence rates (ASPR) and DALYs rates (ASDR) for endometriosis, polycystic ovarian syndrome (PCOS), and unexplained infertility among women of childbearing age using average annual percentage change (AAPC). They evaluated correlations with the Socio-demographic Index (SDI) and calculated age-standardized prevalence and years lived with disability (YLDs) rates of infertility attributable to each condition.
What was found
In 2021, global ASPRs per 100,000 population were 1070.7 for endometriosis (AAPC: -1.02%, declining), 3364.5 for PCOS (AAPC: 0.74%, increasing), and 5586.2 for unexplained infertility (AAPC: 0.70%, increasing). Infertility attributable to these conditions was 60.6 per 100,000 for endometriosis, 638.2 per 100,000 for PCOS, and 5586.2 per 100,000 for unexplained infertility. Regionally, Oceania had the highest ASPR for endometriosis, East Asia for unexplained infertility, and high-income Asia Pacific for PCOS. Infertility attributable to PCOS had higher ASPR and YLDs rates than endometriosis across most regions. ASPRs and ASDRs for endometriosis and unexplained infertility decreased with higher SDI, whereas rates for PCOS increased with higher SDI.
Why it matters
This study quantifies 30-year global trends in major causes of female infertility, demonstrating growing burdens of PCOS and unexplained infertility alongside marked socioeconomic disparities.
Limits
The abstract provides modeled point estimates without uncertainty intervals or underlying primary sample sizes. Because it relies on GBD modeled estimates, findings are subject to cross-country variations in healthcare access, diagnostic criteria, and data availability.
Cited by
- supports Polycystic ovary syndrome (PCOS) and endometriosis are the leading causes of female infertility worldwide.