{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:40:42Z","timestamp":1790811642649,"version":"4.1.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Utilizing the Global Burden of Disease (GBD) 2021 dataset, this study analyzed temporal trends (1990\u20132021) and age-period-cohort patterns of endometriosis-related infertility burden in China versus globally. By employing joinpoint regression and APC modeling, we aimed to identify key epidemiological shifts and disparities, thereby providing evidence-based insights for optimizing health service planning and resource allocation strategies targeting endometriosis-related infertility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using age-standardized prevalence rates (ASPR) of endometriosis-related infertility (1990\u20132021) from the GBD 2021 database, we analyzed Chinese females aged 15\u201349\u202fyears. Joinpoint regression identified significant trend changes in ASPR, while age-period-cohort (APC) modeling decomposed effects into age, period, and birth cohort dimensions using 5-year intervals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 2021, the age-standardized prevalence rate (ASPR) of patients with endometriosis-related primary infertility in China was 280.63 per 100,000 population (95% UI: 115.61 to 616.39). The percentage change in ASPR for endometriosis-associated primary infertility in China between 1990 and 2021 was \u221223.35% (95% UI: \u221210.52% to \u221232.68%) above the global level \u221229.61% (95% UI: \u221237.19% to \u221224.79%). In 2021, the ASPR of patients with endometriosis-associated secondary infertility in China was 1849.35 per 100,000 population (95% UI: 1104.61 to 2931.00). The percentage change of endometriosis-associated secondary between 1990 and 2021 ASPR in China was \u221238.16% (95% UI: \u221243.81% to \u221231.53%), below the global level \u221224.70% (95% UI: \u221227.99% to \u221221.11%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The ASPR of endometriosis-related female infertility in China and globally declined between 1990 and 2021. This indicates that China has attained significant progress in addressing and managing endometriosis-related female infertility. However, the overall burden of endometriosis-related female infertility remains substantial and requires continued attention.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1651254","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T05:35:43Z","timestamp":1759815343000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Endometriosis-related infertility in China: analysis of the global burden of disease study 2021"],"prefix":"10.3389","volume":"13","author":[{"given":"Jianting","family":"Lao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongyi","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panwei","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhua","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"hoac009","DOI":"10.1093\/hropen\/hoac009","article-title":"ESHRE guideline: endometriosis","volume":"2022","author":"Becker","year":"2022","journal-title":"Hum Reprod 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