Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990-2017: results from a global burden of disease study, 2017

Hui Sun, Ting-Ting Gong, Yu-Ting Jiang, Shuang Zhang, Yu-Hong Zhao, Qi-Jun Wu, Hui Sun, Ting-Ting Gong, Yu-Ting Jiang, Shuang Zhang, Yu-Hong Zhao, Qi-Jun Wu

Abstract

To provide comprehensive estimates of the global, regional, and national burden of infertility from 1990 to 2017, using findings from a 2017 study on the global burden of disease (GBD), we assessed the burden of infertility in 195 countries and territories from 1990 to 2017. DisMod-MR 2.1 is a Bayesian meta-regression method that estimates non-fatal outcomes using sparse and heterogeneous epidemiological data. Globally, the age-standardized prevalence rate of infertility increased by 0.370% per year for females and 0.291% per year for males from 1990 to 2017. Additionally, age-standardized disability-adjusted life-years (DALYs) of infertility increased by 0.396% per year for females and 0.293% per year for males during the observational period. An increasing trend to these burden estimates was observed throughout the all socio-demographic index (SDI) countries. Interestingly, we found that high SDI countries had the lowest level of prevalence and DALYs in both genders. However, the largest increasing trend was observed in high-SDI countries for females. By contrast, low-SDI countries had the largest increasing trend in males. Negative associations were observed between these burden estimates and the SDI level. The global disease burden of infertility has been increasing throughout the period from 1990 to 2017.

Keywords: disability-adjusted life-years; female infertility; global burden of disease study; male infertility; prevalence.

Conflict of interest statement

CONFLICTS OF INTEREST: All authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Trends in global disease burden of female infertility prevalence from 1990–2017. (A) Trends in global disease burden of female infertility prevalence by socio-demographic index from 1990–2017; (B) Trends in global disease burden of female infertility prevalence by region from 1990–2017).
Figure 2
Figure 2
Trends in global disease burden of male infertility prevalence from 1990–2017. (A) Trends in global disease burden of male infertility prevalence by socio-demographic index from 1990–2017; (B) Trends in global disease burden of male infertility prevalence by region from 1990–2017).
Figure 3
Figure 3
Trends in global disease burden of 15–44 year-old female infertility prevalence and DALYs from 1990–2017. (A) Prevalence; (B) DALYs).
Figure 4
Figure 4
Trends in global disease burden of 15–44 year-old male infertility prevalence and DALYs from 1990–2017. (A) Prevalence; (B) DALYs).
Figure 5
Figure 5
Global disease burden of female infertility prevalence in 195 countries and territories. (A) The percent change in age-standardized prevalence of female infertility between 1990 and 2017; (B) The estimated annual percentage change of female infertility age-standardized prevalence from 1990 to 2017).
Figure 6
Figure 6
Global disease burden of male infertility prevalence in 195 countries and territories. (A) The percent change in age-standardized prevalence of male infertility between 1990 and 2017; (B) The estimated annual percentage change of male infertility age-standardized prevalence from 1990 to 2017).
Figure 7
Figure 7
Trends in global disease burden of female infertility disability-adjusted life-years from 1990–2017. (A) Trends in global disease burden of female infertility disability-adjusted life-years by socio-demographic index from 1990–2017; (B) Trends in global disease burden of female infertility disability-adjusted life-years by region from 1990–2017).
Figure 8
Figure 8
Trends in global disease burden of male infertility disability-adjusted life-years from 1990–2017. (A). Trends in global disease burden of male infertility disability-adjusted life-years by socio-demographic index from 1990–2017; (B). Trends in global disease burden of male infertility disability-adjusted life-years by region from 1990–2017).
Figure 9
Figure 9
Global disease burden of female infertility disability-adjusted life-years in 195 countries and territories. (A). The percent change in age-standardized disability-adjusted life-years of female infertility between 1990 and 2017; (B) The estimated annual percentage change of female infertility age-standardized disability-adjusted life-years from 1990 to 2017).
Figure 10
Figure 10
Global disease burden of male infertility disability-adjusted life-years in 195 countries and territories. (A). The percent change in age-standardized disability-adjusted life-years of male infertility between 1990 and 2017; (B). The estimated annual percentage change of male infertility age-standardized disability-adjusted life-years from 1990 to 2017).
Figure 11
Figure 11
Co-evolution of age-standardized burden estimates with SDI globally and for GBD regions for female infertility from 1990–2017. (A). Prevalence (B) DALYs. Colored lines show global and region values for age-standardized burden estimates rates. Each point in a line represents 1 year starting at 1990 and ending at 2017. The black line represents the average expected relationship between SDI and burden estimates rates for female infertility based on values from each region in the 1990–2017 estimation period. DALYs = disability-adjusted life-years. SDI = Socio-demographic Index.
Figure 12
Figure 12
Co-evolution of age-standardized burden estimates with SDI globally and for GBD regions for male infertility 1990–2017. (A) Prevalence (B) DALYs. Colored lines show global and region values for age-standardized burden estimates rates. Each point in a line represents 1 year starting at 1990 and ending at 2017. The black line represents the average expected relationship between SDI and burden estimates rates for male infertility based on values from each region in the 1990–2017 estimation period. DALYs = disability-adjusted life-years. SDI = Socio-demographic Index.

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