Disease burden of infertility in five East Asian countries from 1990 to 2021 and prediction for 2050: An analysis of the Global Burden of Disease study 2021.

Abstract

With the development of society, fertility seems to have become a public health issue in East Asian countries. At present, there is insufficient attention to infertility, especially male infertility. Understanding the burden and trends of infertility in men and women aged 20-49 years in East Asia is essential for fertility issues. The related data in China, Democratic People's Republic of Korea, Japan, Mongolia and Republic of Korea, was extracted from the Global Burden of Disease (GBD) Study 2021 including prevalence, disability-adjusted life-year (DALY), age-standardized prevalence rate (ASPR) and age-standardized DALY rate. Annual percentage change (APC) and average annual percentage change (AAPC) were conducted by joinpoint analysis. The impact of age, period and birth cohort on the infertility was calculated by age-period-cohort model. We also predicted the future burden of infertility using Bayesian age period cohort (BAPC) analysis. The burden of infertility aged 20-49 years group varied across five East Asian countries from 1990 to 2021, in which the trend of China (AAPC: FI 0.12, 95%UI: 0.01 to 0.22; MI 0.14, 95%UI: 0.02 to 0.27) and Mongolia (AAPC: FI 0.3, 95%UI: 0.24 to 0.35; MI 0.25, 95%UI: 0.21 to 0.28) showed increased, and the others were stable. The risk of male prevalence was significantly higher than that of female in two developed countries, while it was contrary in three developing countries. The burden of infertility increased with age in developing countries and reached the highest at the age of 35-39. In developed countries, the 40-44 age group has the highest burden of infertility. The future burden of infertility showed a downward trend to 2050 in China and Democratic People's Republic of Korea, while it predicted to increase in Japan, Mongolia and Republic of Korea. These differences may be affected by socio-economic factors and health policies, highlighting significant differences between countries. The infertility burden in the five East Asian countries aged 20-49 years varies among age group and gender from 1990 to 2021, which is still a public threat. It is necessary to formulate appropriate strategies according to different situations to alleviate the burden of infertility.