Recent research from Johns Hopkins Medicine has found that the rate of infertility in women in the United States has remained largely unchanged in the past few decades. The study, published on June 14 in Fertility and Sterility, analyzed data from 1995 to 2019 and revealed that infertility is more prevalent among older women, non-Hispanic Black women, and those with lower income or education levels, as well as those without access to reproductive health services.
Infertility, defined as the inability to conceive after one year of unprotected sex, impacts millions of men and women of reproductive age. Studies in the early 2000s showed a decline in infertility rates during the 1980s and 1990s, though the reasons for this drop were unclear.
Experts now believe that rising rates of sexually transmitted infections (STIs), which have consistently increased over the years, may be contributing to higher infertility rates. Additionally, fewer women are receiving preventive gynecologic care, and the average age of first-time mothers has been rising.
Maria Trent, M.D., M.P.H., a senior author of the study and Bloomberg Professor at Johns Hopkins University, explained, “This is a unique time where STIs are increasing, and emerging threats to healthcare access are impacting women’s fertility.” She stressed the importance of understanding how these factors may influence fertility.
The study examined data from 53,764 women who participated in the National Survey of Family Growth (NSFG), a federally supported survey. Though the survey did not directly ask about infertility, it included questions about sexual activity, contraception, and pregnancy, providing new insights into infertility trends.
The researchers found that infertility rates fluctuated slightly over the years, with a low of 5.8% from 2006 to 2010 and a high of 8.1% from 2017 to 2019. However, these changes were not statistically significant, indicating that infertility rates remained largely steady throughout the study period.
The study also found that certain populations were disproportionately affected by infertility. Women aged 40 to 44 were 11 times more likely to experience infertility than younger women, while women without a high school diploma were twice as likely to be infertile as those with higher education levels. Non-Hispanic Black women had a 44% higher likelihood of infertility compared to women of other races. Women who had not recently received sexual health care were 61% more likely to experience infertility.
Trent emphasized, “These findings show that fertility remains a significant issue, particularly among vulnerable groups.” She noted that understanding the populations at greatest risk could help inform public health policies. For example, improving access to sexual health care and addressing STIs could reduce infertility rates, as untreated infections like pelvic inflammatory disease are a major contributor to infertility.
While the study’s reliance on the NSFG data, which was not specifically designed to measure infertility, is a limitation, it offers valuable comparisons to previous research. The authors call for further studies to explore the complex factors that influence infertility.
This research was supported by the National Institute of Nursing Research, and the authors also included Jamie Perin, Ph.D., and Tyler Vranich, M.S., both of Johns Hopkins University.
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