Infertility has aroused extensive concerns. As for China, little is known about the recent epidemiology of infertility in Chinese reproductive population. We tried to investigate infertility rate and possible risk factors in Chinese through both Global Burden of Disease (GBD) study and Chinese Health and Retirement Longitudinal Study (CHARLS).

Cross-sectional data were obtained from GBD and CHARLS, two large databases exploring numerous disease burden and risk factor pattern at global and national level. We tried to illustrate the global trend of infertility and infertility risk factor pattern in China. Data analysis adjusted with sampling weight was utilized.

From 1990 to 2019, the number of infertility population has increased stably year by year, regardless of gender. The female group was approximately twice the male group. In China, the age-standardized prevalence of infertility was stable during the past three decades. However, the number was extremely high compared with global age-standardized infertility prevalence, especially for female infertility. The risk pattern of infertility in China presented with different characteristics in different gender groups. Furthermore, we calculated prevalence of infertility among different provinces in China in 2015. Overall prevalence of infertility in Chinese population was 0.49 (95% CI: 0.48-0.50).

We were able to observe that the general burden of infertility to the world was disastrous when taking number of prevalence, DALYs and YLDs into account. Countries with high-middle or middle SDI enjoyed the most portion after adjusted for age. And China was considered to lie in middle SDI subgroup, where infertility was out of question a big challenge to both the government and the world. We could also confirm the situation when Figure 2B indicated the age-standardized prevalence of infertility in China was higher than that around the world independent of gender and year. The univariate and multivariate logistic regression indicated different patterns of risk and protective factors for female and male infertility. Top 3 provinces with the lowest prevalence of infertility were recognized as advanced regions with highest gross domestic product (GDP) per capita. The burdens and challenges of infertility still needed to be paid attention to and dealt with in China.

Prevalence of infertility was still a concern to both the world and China. In China, the risk pattern presented with different characteristics in different gender groups. The data might instruct further policy making and medical work promoting in China. We were also looking forward to a more recent population-based study with more information pertinent to infertility to be conducted in China.