Escalating global burden of female infertility: Age-stratified trends, socioeconomic disparities, and post-COVID-19 projections (1990-2035).

This study explores the global burden of female infertility across 204 countries and 21 regions from 1990 to 2021. The population-based study analyzed was conducted using data from the Global Burden of Disease 2021. We assessed age-standardized prevalence rate (ASPR), age-standardized incidence rate, disability-adjusted life years rate, and trends via average annual percent change, with projections to 2035 using the Bayesian age-period-cohort model. The outcomes revealed that female infertility sustained a global rise in ASPR (0.66% annually) and disability-adjusted life years (0.68% annually), driven by population growth and aging. Notably, while the 35 to 39 age group exhibited the highest prevalence, the 20 to 29 age group showed the fastest growth rate (average annual percent change = 1.04%), signaling a younger-onset trend. Socioeconomic disparities were prominent: low-middle sociodemographic index regions experienced the steepest ASPR increases (1.23% annually), contrasting with high sociodemographic index areas. During 2019 to 2021, ASPR stabilized, potentially linked to COVID-19-related population shifts rather than direct biological effects. Projections indicate a persistent burden, with ASPR reaching 6458.26/100,000 by 2035. These findings underscore the urgent need for targeted interventions addressing socioeconomic inequities, younger demographic risks, and sustainable reproductive health policies to mitigate the escalating global challenge of female infertility.