The prevalence of couple infertility in the United States from a male perspective: evidence from a nationally representative sample.
The prevalence of couple infertility in the United States from a male perspective: evidence from a nationally representative sample.
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DOI：
10.1111/j.2047-2927.2013.00110.x
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发表时间：
2013-09
期刊：
影响因子：
4.5
通讯作者：
Buck Louis GM
中科院分区：
文献类型：
--
作者：
Louis JF;Thoma ME;Sørensen DN;McLain AC;King RB;Sundaram R;Keiding N;Buck Louis GM
不孕症是一种基于夫妻生育能力受损的疾病，尽管人口水平的研究主要基于女性伴侣报告的信息。在少数关注男性伴侣的研究中，大多数关注的是不孕症服务的利用，而不是努力估计男性伴侣报告的不孕症的患病率和决定因素。从参加2002年全国家庭成长调查（NSFG）的具有全国代表性的15-44岁男性样本中获得的数据被用于使用新的当前持续时间方法来估计不孕症的患病率和更长的怀孕时间（TTP）的决定因素。使用向后复发时间参数生存法，我们估计了不孕症患病率（TTP bbb12个月）和TTP相关的时间比（TR），这些数据来自于男性报告的当前妊娠尝试时间。估计不孕症患病率为12.0% （95% CI: 7.0, 23.2）。在控制夫妻年龄和其他社会经济因素的差异后，较长的TTP与男性年龄较大（35-45岁vs. 17-24岁）（TR: 2.49; 95% CI: 1.03, 6.03）、无生儿育女（TR: 1.53; 95% CI: 1.07, 2.19）和缺乏健康保险（TR: 1.73; 95% CI: 1.02, 2.94）相关。基于男性报告的不孕症患病率与美国前瞻性队列研究和当前基于女性报告的持续研究中发现的不孕症患病率一致。我们的研究结果表明，男性可以可靠地告知夫妇不孕。旨在减少夫妇不育的干预措施和服务应包括关注与本研究确定的TTP较长相关的男性因素。
Infertility is a couple based fecundity impairment, though 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 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 current duration 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 United States found in prospective cohort studies and current duration studies based on female reporting. Our findings suggest that males 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.
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