# Trends in global and national infertility and factors associated with primary infertile couples in recent middle-aged Chinese

## TL;DR

This study examines infertility trends in China and finds that anxiety is linked to primary infertility among middle-aged couples.

## Contribution

The study provides new insights into primary infertility rates and associated factors in middle-aged Chinese couples.

## Key findings

- The global infertility population has steadily increased from 1990 to 2019.
- The age-standardized infertility rate in China is higher than the global average.
- Anxiety is identified as a significant factor associated with primary infertility in middle-aged Chinese couples.

## Abstract

Infertility poses a significant burden on both global and national scales. However, the epidemiology of primary infertility among reproductive-aged couples in China remains poorly understood. Therefore, this study aimed to investigate the global infertility rate and identify factors associated with primary infertility among middle-aged couples in China.

Cross-sectional data were derived from the Global Burden of Disease (GBD) study and the Chinese Health and Retirement Longitudinal Study (CHARLS), two extensive databases that examined various disease burdens and associated factors at both global and national levels.

From 1990 to 2019, the global infertility population has shown a steady annual increase. In China, the age-standardized prevalence rate of infertility has remained relatively stable over the past three decades. However, this rate was notably higher than the global age-standardized infertility prevalence rate. Our analysis revealed that the prevalence of primary infertility among middle-aged Chinese couples was approximately 1.7% (947,953/56,892,517). Additionally, we identified anxiety as an associated factor with infertility, highlighting the need for increased public attention to mental health in China.

Infertility continued to be a pressing issue on both global and national levels. This situation warranted widespread attention from Chinese policymakers and healthcare managers. The findings might guide future policy-making and medical interventions in China, with a particular focus on supporting the reproductive needs of middle-aged individuals.