The prevalence of infertility in the United States as estimated by the current duration approach and a traditional construct approach

Thursday, October 11, 2012 — Poster Session III
10:00 a.m. – Noon	Natcher Conference Center, Building 45	NICHD	EPID-23

Authors

• ME Thoma
• AC McLain
• JF Louis
• RB King
• AC Trumble
• R Sundaram
• GM Buck Louis

Abstract

Background: The current-duration (CD) design is a novel approach for estimating a time-to-pregnancy (TTP) distribution from cross-sectional data and, to our knowledge, has not been applied to U.S. populations. Objective: To estimate the prevalence of infertility using a CD approach for comparison with the traditional construct measure from the 2002 National Survey of Family Growth (NSFG). Methods: Infertility prevalence was estimated by two approaches: 1) a construct measure derived from questions on sexual activity, contraception, and pregnancy status, and 2) a measure derived from a question on duration of current pregnancy attempt (i.e., CD approach). Covariate associations were assessed using weighted logistic regression or accelerated-failure-time models, respectively. Results: Infertility prevalence was approximately twofold higher using the current duration approach (15.5%; 95% confidence interval [CI]: 8.6, 27.5) versus the construct measure (7.0%; 95% CI: 6.2, 7.9). Both methods identified increasing age, nulliparity, and history of gynecologic disorders as being associated with reduced fertility, while opposing patterns were seen for racial/ethnic identification and poverty level. Conclusion: Infertility estimates based on the current duration approach were consistent with other U.S. prospective cohort studies with preconception enrollment (12-18%). These findings underscore the importance of definition and methodologic approach on our understanding of infertility.

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