The global impact of female infertility: regional disparities and future projections from the GBD 2021 study.
Level 4 - case-series / case-control
Ecological epidemiological modeling study using secondary Global Burden of Disease 2021 data
PubMed 42487333 · doi:10.1080/09513590.2026.2697103
What was done
Using data from the Global Burden of Disease (GBD) Study 2021, the authors evaluated the spatiotemporal distribution of female infertility from 1990 to 2021 and modeled projected trends through 2050 across 204 countries and territories. Prevalence, disability-adjusted life years (DALYs), and age-standardized rates were analyzed across Socio-demographic Index (SDI) strata. Estimated Annual Percentage Change (EAPC) was used to quantify temporal trends, and Bayesian Age-Period-Cohort models were used for forecasting.
What was found
Global female infertility cases increased by 84.4%, rising from 59.69 million in 1990 to 110.09 million in 2021, with an age-standardized prevalence rate EAPC of 0.70. High-middle and Middle SDI regions accounted for the largest absolute burden, whereas High SDI regions had the fastest rate of increase (EAPC = 1.43). In High SDI countries, peak prevalence shifted to the 40–44 age group compared to the global peak at 35–39 years. Burdens were projected to continue increasing across all cohorts through 2050.
Why it matters
The study maps long-term global and regional trends in female infertility, highlighting distinct regional patterns such as delayed childbearing in developed nations and metabolic/infectious drivers in middle-income countries to inform targeted reproductive healthcare policies.
Limits
The analysis relies on secondary modeling from the GBD study rather than primary clinical cohorts, making it vulnerable to variations in regional data completeness and reporting quality. The abstract does not provide confidence/uncertainty intervals for the estimates and does not specify how differences in clinical diagnostic criteria across countries were handled.
Cited by
- supports Infertility rates have steadily climbed over the past several decades, with estimates suggesting nearly one in five couples struggle to conceive.