No change in past decades in female infertility rate

WEDNESDAY, June 22, 2022 (HealthDay News) — After years of decline, infertility rates among American women have remained stable over the past decade, according to a new study.

The reasons for the dropout are unclear. But the researchers said increasing rates of sexually transmitted diseasesand unequal access to reproductive health care could be factors.

The study found that from 2006 to 2019, infertility rates among American women aged 15 to 44 fluctuated between about 6% and 8%.

This contrasts with previous years, which saw a downward trend in infertility rates nationwide, despite more women delaying childbirth.

“Infertility is still a problem for women in the United States. It hasn’t gone away,” said Dr. Maria Trent, the study’s lead researcher and a professor at Johns Hopkins University School of Medicine. in Baltimore.

“A lot of times we don’t talk about infertility, because it’s scary,” Trent added.

But women should be aware that some infertility risk factors can be changed, researchers say. One is pelvic inflammatory disease (PID), a bacterial infection that damages the reproductive organs and leads to fertility problems in some women. PID is often a complication of sexually transmitted infections chlamydia and gonorrhea.

Trent pointed out that Americans’ STD rates have skyrocketed in recent years.

About 20 years ago, gonorrhea rates were at historic lows in the United States, according to the US Centers for Disease Control and Prevention. But in 2019, the country marked its sixth consecutive year of record STD rates – with approximately 2.5 million Americans diagnosed with gonorrhea, chlamydia or syphilis.

This trend may be contributing to the stagnant decline in female infertility, according to Trent.

Specifically, lack of diagnosis and treatment of STDs may be to blame: in this study, women who reported not having been tested or treated for an STD in the past year were more likely to report difficulty conceiving.

Trent worries that continuing threats to women’s access to reproductive health care are making matters worse.

The results β€” recently published online in the journal Fertility and sterilityβ€” are based on nearly 54,000 married or cohabiting American women who participated in a long-running federal survey called the National Survey for Family Growth.

Previous studies based on the same survey found a decline in infertility: from 8.5% in the early 1980s to around 6% between 2006 and 2010. (Infertility was defined as not conceiving after at least one year of trials, with the same partner. )

Trent’s team found that since this 2006-2010 period, the infertility rate has remained stable, peaking at 8% in 2017-2019 (a change that was not statistically significant).

Other research has suggested that the rate of infertility among American women may be even higher. A team from the University of Michigan found a prevalence of infertility of about 12.5% ​​in recent years among people aged 20 to 44.

In this studyinfertility affected women equally, regardless of race, income, or education.

But there were striking differences in the likelihood of receiving treatment, said Dr James Dupree, clinical associate professor of urology who worked on the study.

For example, more than 80% of women with a college degree said they had sought care for their fertility issues, compared to only a third of those with only a high school diploma.

It’s unclear why, Dupree said, but there could be plenty of hurdles. The cost is obvious, especially since insurance plans don’t always cover infertility treatment. Beyond that, Dupree said, people may not live near a provider because the United States has infertility care “deserts.” Other people, he noted, may not have jobs that allow them time off for medical care.

And in some cases, Dupree said, couples may not know help is available. In general, he noted, if a couple has been trying to conceive for a year without success (or six months, if the woman is over 35), it’s recommended that both partners get an evaluation.

Trent emphasized the importance of reproductive health care from the start – including STD screening. The CDC advises all sexually active women under age 25 to get tested annually for gonorrhea and chlamydia; screening is also recommended for older women when they have a new partner or risk factors for STDs, such as multiple sexual partners.

And anyone with symptoms of PID “should seek treatment immediately,” Trent said.

These symptoms include pain in the lower abdomen, pain during intercourse, burning during urination, and unusual vaginal discharge, although some women have no symptoms.

More information

The US Centers for Disease Control and Prevention has more on infertility.

SOURCES: Maria Trent, MD, MPH, professor of pediatrics, Johns Hopkins University School of Medicine, and professor, American Health, Johns Hopkins Bloomberg School of Public Health, Baltimore; James Dupree, MD, MPH, clinical associate professor, urology, Michigan Medicine, and fellow, Institute for Health Policy and Innovation, University of Michigan, Ann Arbor; Fertility and sterilityJune 14, 2022, online

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