Aim: Infertility is a growing global health issue affecting millions worldwide. While endometriosis, polycystic ovarian syndrome (PCOS) and unexplained infertility are recognized as the major contributors, their specific burden and impact on infertility among women of childbearing age (WCBA) remain inadequately quantified. This study aimed to evaluate the global burden of three diseases and infertility attributable to them.
Methods: Using data from Global Burden of Disease Study 2021, we assessed the temporal trends of three diseases by average annual percentage change (AAPC) in age-standardized prevalence rate (ASPR) and DALYs rate (ASDR), and evaluated their correlation with socio-demographic index (SDI). We also calculated the age-standardized prevalence and years lived with disability (YLDs) rates of infertility attributable to three diseases.
Results: In 2021, the global ASPRs of endometriosis, PCOS, and unexplained infertility were 1070.7 (AAPC: –1.02%, declining), 3364.5 (AAPC: 0.74%, increasing), and 5586.2 (AAPC: 0.70%, increasing), and infertility attributable to three diseases were 60.6, 638.2, and 5586.2 per 100,000 population, respectively. Regionally, Oceania had the highest ASPR for endometriosis, East Asia for unexplained infertility, and high-income Asia Pacific for PCOS. Infertility attributable to PCOS exhibited higher age-standardized prevalence and YLDs rates compared to endometriosis in most regions. Notably, ASPRs and ASDRs for endometriosis and unexplained infertility decreased with SDI, while PCOS rates increased with SDI.
Conclusions: The increasing global burden of endometriosis, PCOS, and unexplained infertility among WCBA has significantly contributed to rising infertility rates, with distinct regional and demographic disparities. Targeted public health strategies are needed to address these trends.
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2025 The Author(s). Journal of Evidence-Based Medicine published by Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.
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