{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T20:22:03Z","timestamp":1793650923456,"version":"4.5.1"},"reference-count":21,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T00:00:00Z","timestamp":1722297600000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010248","name":"Public Welfare Technology Application Research Project of Zhejiang Province","doi-asserted-by":"crossref","award":["LGF22H200013"],"award-info":[{"award-number":["LGF22H200013"]}],"id":[{"id":"10.13039\/501100010248","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Zhejiang Provincial Medical and Health Science and Technology Project","award":["2022KY1228"],"award-info":[{"award-number":["2022KY1228"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,7,2]]},"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this analysis was to investigate the worldwide distribution and trends in the burden of female infertility (FI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and setting<\/jats:title>\n                    <jats:p>Analysis of cross-sectional data from 1990 to 2019 from the Global Burden of Disease (GBD) Study 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults aged 20\u201349 years in various geographical regions, Sociodemographic Index (SDI) levels and populations across 204 countries worldwide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Disability-adjusted life years (DALYs), age-standardised DALY rates and estimated annual percentage changes (EAPCs) for FI over the research period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The global burden of FI, as measured by DALYs and age-standardised DALY rates among adults aged 20\u201349 years, exhibited an upward trend from 1990 to 2019. Regions such as Tropical Latin America (EAPC: 3.76, 95%\u2009CI 2.76 to 4.77), South Asia (EAPC: 1.74, 95%\u2009CI 1.01 to 2.48) and Andean Latin America (EAPC: 8.54, 95%\u2009CI 6.79 to 10.32) had higher DALYs. The age-standardised DALY rates notably increased in low-middle-SDI and low-SDI countries, with EAPCs of 1.42 (95% CI 0.76 to 2.10) and 1.25 (95% CI 0.30 to 2.21), respectively. Despite lower overall DALYs in high-SDI countries, they experienced the highest EAPC in DALYs (1.57, 95%\u2009CI 1.30 to 1.83) during the period 1990\u20132019. China and India consistently had the highest DALYs for FI globally in both 1990 and 2019, while Africa and Latin America bore a significantly greater burden of the disease compared with other regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The GBD Study data on FI among adults aged 20\u201349 years revealed a rising global trend in FI from 1990 to 2019, with notable variations across different regions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-084755","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T22:58:21Z","timestamp":1722380301000},"page":"e084755","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Trends in the burden of female infertility among adults aged 20\u201349 years during 1990\u20132019: an analysis of data from the Global Burden of Disease Study 2019"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0790-5416","authenticated-orcid":false,"given":"Yijie","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Gynecology, The Affiliated People's Hospital of Ningbo University, Ningbo, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Huzhou Maternal and Child Health Hospital, Huzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongfeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gynecology, The Affiliated People's Hospital of Ningbo University, Ningbo, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiao","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Gynecology, The Affiliated People's Hospital of Ningbo University, Ningbo, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,7,30]]},"reference":[{"key":"2025120618330955000_14.7.e084755.1","doi-asserted-by":"crossref","first-page":"10952","DOI":"10.18632\/aging.102497","article-title":"Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990\u20132017: results from a global burden of disease study, 2017","volume":"11","author":"Sun","year":"2019","journal-title":"Aging (Milano)"},{"key":"2025120618330955000_14.7.e084755.2","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1590\/0004-2730000003021","article-title":"Female infertility of endocrine origin","volume":"58","author":"Weiss","year":"2014","journal-title":"Arq Bras Endocrinol Metab"},{"key":"2025120618330955000_14.7.e084755.3","first-page":"1735","article-title":"Assessing the trend of infertility rate in 198 countries and territories in last decades","volume":"50","author":"Borumandnia","year":"2021","journal-title":"Iran J Public Health"},{"key":"2025120618330955000_14.7.e084755.4","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.1016\/S0140-6736(24)00550-6","article-title":"Global fertility in 204 countries and territories, 1950\u20132021, with forecasts to 2100: a comprehensive demographic analysis for the global burden of disease study 2021","volume":"403","author":"Bhattacharjee","year":"2024","journal-title":"Lancet"},{"key":"2025120618330955000_14.7.e084755.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30925-9"},{"key":"2025120618330955000_14.7.e084755.6","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-01990-1"},{"key":"2025120618330955000_14.7.e084755.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.12.001"},{"key":"2025120618330955000_14.7.e084755.8","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3733"},{"key":"2025120618330955000_14.7.e084755.9","doi-asserted-by":"crossref","DOI":"10.3389\/fcimb.2022.861053","article-title":"Global burden, incidence and disability-adjusted life-years for dermatitis: a systematic analysis combined with socioeconomic development status, 1990\u20132019","volume":"12","author":"Xue","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"key":"2025120618330955000_14.7.e084755.10","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.4314\/ahs.v20i4.57","article-title":"Infertility and associated factors in three hospitals in douala, cameroon: a cross-sectional study","volume":"20","author":"Obinchemti Egbe","year":"2020","journal-title":"Afr H Sci"},{"key":"2025120618330955000_14.7.e084755.11","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deq189"},{"key":"2025120618330955000_14.7.e084755.12","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0291912","article-title":"The prevalence of infertility and factors associated with infertility in ethiopia: analysis of ethiopian demographic and health survey (EDHS)","volume":"18","author":"Legese","year":"2023","journal-title":"PLOS ONE"},{"key":"2025120618330955000_14.7.e084755.13","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/S1472-6483(10)60337-9","article-title":"Affordable IVF for developing countries","volume":"15","author":"Ombelet","year":"2007","journal-title":"Reprod Biomed Online"},{"key":"2025120618330955000_14.7.e084755.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2005.08.066"},{"key":"2025120618330955000_14.7.e084755.15","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000033849","article-title":"The association between aldehydes exposure and female infertility: A cross-sectional study from NHANES","volume":"102","author":"Zhang","year":"2023","journal-title":"Medicine (Baltimore)"},{"key":"2025120618330955000_14.7.e084755.16","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0289096","article-title":"Surging trends of infertility and its behavioural determinants in india","volume":"18","author":"Kundu","year":"2023","journal-title":"PLOS ONE"},{"key":"2025120618330955000_14.7.e084755.17","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001356","article-title":"National, regional, and global trends in infertility prevalence since 1990: A systematic analysis of 277 health surveys","volume":"9","author":"Mascarenhas","year":"2012","journal-title":"PLoS Med"},{"key":"2025120618330955000_14.7.e084755.18","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-042951","article-title":"Economic costs of infertility care for patients in low-income and middle-income countries: a systematic review protocol","volume":"10","author":"Njagi","year":"2020","journal-title":"BMJ Open"},{"key":"2025120618330955000_14.7.e084755.19","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmv016"},{"key":"2025120618330955000_14.7.e084755.20","doi-asserted-by":"publisher","DOI":"10.1001\/JAMA.2021.4788"},{"key":"2025120618330955000_14.7.e084755.21","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dem431"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-084755","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T02:33:19Z","timestamp":1765074799000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-084755"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":21,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7,30]]},"published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1136\/bmjopen-2024-084755"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-084755","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7]]}}}