The global impact of female infertility: regional disparities and future projections from the GBD 2021 study.

OBJECTIVE

Female infertility is an escalating global health challenge. Utilizing data from the Global Burden of Disease Study 2021, this study analyzed the spatiotemporal distribution of female infertility (1990-2021) and projected trends through 2050.

METHODS

We evaluated prevalence, disability-adjusted life years (DALYs), and age-standardized rates across 204 countries, stratified by Socio-demographic Index (SDI). Temporal trends were quantified using Estimated Annual Percentage Change (EAPC), and future burdens were forecasted via Bayesian Age-Period-Cohort models.

RESULTS

Global female infertility cases surged by 84.4%, rising from 59.69 million in 1990 to 110.09 million in 2021, with the age-standardized prevalence rate (ASPR) trending upward (EAPC=0.70). While High-middle and Middle SDI regions bore the largest absolute burden-driven by persistent infections and metabolic risks-High SDI regions exhibited the steepest increase (EAPC=1.43). This rapid rise in developed nations aligns with delayed childbearing, evidenced by a peak prevalence shift to the 40-44 age group, contrasting with the global peak at 35-39 years. Projections indicate a continued ascent in burden across all cohorts through 2050.

CONCLUSIONS

The global burden of female infertility is rising and spatially distinct. Transitioning economies face high baseline rates, yet developed nations show the fastest growth, demanding urgent action. Strategies must be tailored to regional drivers: prioritizing infection control and metabolic health in middle-income settings, and fertility support policies in high-income regions.