Abstract

Research question: The prevalence of infertility in couples actively trying to conceive is 25%. What is the consultation-seeking behaviour, diagnosis and related treatment in infertile couples across China? Design: Large cross-sectional population-based study in 2010–2011, in which 25,270 couples from eight provinces/municipalities in China were approached by a multistage stratified cluster sampling strategy. Results: Among the 2680 couples reporting infertility, 1246 infertile couples consulted a fertility doctor. Age of the couple, man's body mass index and women's educational level were found to be associated with consultation behaviour. After the fertility work-up, diagnoses were tubal infertility (n = 353, 28.3%), unexplained infertility (n = 311, 25.0%), male infertility (n = 234, 18.8%), ovulatory disorder (n = 194, 15.6%) and endometriosis (n = 34, 2.7%), while 8.6% (n = 107) were not classified. Most couples received non-assisted reproductive technology (ART) fertility treatment (n = 906, 89.3%), with a proportion using traditional Chinese medicine (TCM) (n = 298, 29.4%). Intrauterine insemination (n = 62, 6.1%) and IVF/intracytoplasmic sperm injection (n = 57, 5.6%) were less frequent. Medical treatment and outcomes among five subtypes of infertility were also reported: about 30% of couples with unexplained infertility (n = 94, 30.3%) or male infertility (n = 67, 29.0%) used TCM to treat infertility. Apart from patients with endometriosis, of whom 20.6% (n = 7) received ART, patients with other infertility subtypes rarely received ART. For subsequent fertility outcome, 94% of them did not achieve a pregnancy. Conclusion: The prevalence of infertility in China is high, but the uptake of treatment is relatively low.

Original languageEnglish
Pages (from-to)917-925
Number of pages9
JournalReproductive Biomedicine Online
Volume38
Issue number6
Early online date8 Jan 2019
DOIs
Publication statusPublished - 1 Jun 2019

Bibliographical note

Acknowledgements
We thank the thousands of health workers who have contributed to data collection at the provincial, city, township and village levels. We are grateful to Professor He-Feng Huang (the Chairman of the Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, during the time period of the survey) for her coordination of the investigation in Zhejiang Province. We thank Professor Canquan Zhou (the Chairman of CSRM during the time period of the survey) for his coordination and organization throughout implementation of the project. We also appreciate the efforts of Doctor Geng Yu during the preparation and execution phases of this study.

Funding

This study was supported by Assisted Reproductive Technology Development Cooperation Projects from the Centre for International Exchange and Cooperation of the National Health and Family Planning Commission of the People's Republic of China (No. [2010]237), the National Key Technology R&D Program in the Twelfth Five-Year Plan (No. 2012BAI32B01), the Research Fund of the National Health and Family Planning Commission of China (No. 201402004), and the National Key Research and Development Program (No. 2018YFC1002102). The study funders had no role in the study design, implementation, analysis, manuscript, preparation or decision to submit this article for publication.

Keywords

  • Consultation-seeking behaviour
  • Diagnosis
  • Infertility
  • Treatment

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