title: The prevalence of couple infertility in the United States from a male perspective: evidence from a nationally representative sample.
abstract: Infertility is a couple-based fecundity impairment, although population level research is largely based upon information reported by female partners. Of the few studies focusing on male partners, most focus on the utilization of infertility services rather than efforts to estimate the prevalence and determinants of infertility as reported by male partners. Data from a nationally representative sample of men aged 15-44 years who participated in the 2002 National Survey of Family Growth (NSFG) were used to estimate the prevalence of infertility and determinants of longer time-to-pregnancy (TTP) using the novel current duration (CD) approach. Using backward recurrence time parametric survival methods, we estimated infertility prevalence (TTP > 12 months) and time ratios (TR) associated with TTP as derived from males' reported CD of their pregnancy attempt. The estimated prevalence of infertility was 12.0% (95% CI: 7.0, 23.2). Longer TTP was associated with older male age (35-45 vs. 17-24 years) (TR: 2.49; 95% CI: 1.03, 6.03), biological childlessness (TR: 1.53; 95% CI: 1.07, 2.19) and lack of health insurance (TR: 1.73; 95% CI: 1.02, 2.94) after controlling for the differences in couples' age and other socioeconomic factors. The prevalence of infertility based on male reporting is consistent with estimates of infertility in the US found in prospective cohort studies and CD studies based on female reporting. Our findings suggest that male partners can reliably inform about couple infertility. Interventions and services aimed at reducing couple infertility should include attention to male factors associated with longer TTP identified in this study.
authors.affiliation: Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD, USA.
authors.forename: J F
authors.initials: JF
authors.lastname: Louis
authors.forename: M E
authors.initials: ME
authors.lastname: Thoma
authors.forename: D N
authors.initials: DN
authors.lastname: Sørensen
authors.forename: A C
authors.initials: AC
authors.lastname: McLain
authors.forename: R B
authors.initials: RB
authors.lastname: King
authors.forename: R
authors.initials: R
authors.lastname: Sundaram
authors.forename: N
authors.initials: N
authors.lastname: Keiding
authors.forename: G M
authors.initials: GM
authors.lastname: Buck Louis
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology*; D007248:Infertility, Male / Q000453:epidemiology*; D008297:Male; D017057:Medically Uninsured; D011247:Pregnancy; D015995:Prevalence; D011795:Surveys and Questionnaires; D061685:Time-to-Pregnancy; D014481:United States / Q000453:epidemiology; D055815:Young Adult