Prevalence of infertility in the United States as estimated by the current duration approach and a traditional constructed approach

The prevalence of infertility in the United States was approximately twofold higher when estimated by a current duration approach vs. a traditional constructed measure (15.5% vs. 7.0%, respectively).


Marie E. Thoma, Ph.D., Alexander C. McLain, Ph.D., Jean Fredo Louis, B.S., Rosalind B. King, Ph.D., Ann C. Trumble, Ph.D., Rajeshwari Sundaram, Ph.D., Germaine M. Buck Louis, Ph.D.

Volume 99, Issue 5, Pages 1324-1331.e1, April 2013



To estimate the prevalence of infertility using a current duration approach for comparison with a traditional constructed measure.


Cross-sectional survey.


National Survey of Family Growth, United States, 2002.


A nationally-representative sample of females aged 15-44 years.



Main Outcome Measure(s):

Infertility prevalence estimated by two approaches: 1) a constructed measure derived from questions on sexual activity, contraception, relationship status, and pregnancy, and 2) a measure based on estimated time-to-pregnancy (TTP) derived from the respondents’ current duration of pregnancy attempt (i.e., current duration approach). Associations with self-reported descriptive characteristics using weighted logistic regression or parametric survival models for each respective approach.


Infertility prevalence was approximately twofold higher using the current duration approach (15.5%; 95% CI: 8.6, 27.5) versus the constructed measure (7.0%; 95% CI: 6.2, 7.8). Both methods identified similar patterns of increasing age, lower education, nulliparity, and history of gynecologic disorders as being associated with measures of impaired fecundity, while opposing patterns were seen for racial/ethnic identification and poverty status.


Infertility prevalence based on a current duration approach was consistent with other U.S. prospective cohort studies with preconception enrollment. These findings underscore the importance of definition and methodologic approach for estimating the prevalence of infertility.

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