Consultation and treatment behaviour of infertile couples in China: a population-based study

Abstract Research question The prevalence of infertility in couples actively trying to conceive is 25%. What is the consultation-seeking behaviour, diagnosis and related treatment in infertile couples across China? Design Large cross-sectional population-based study in 2010–2011, in which 25,270 couples from eight provinces/municipalities in China were approached by a multistage stratified cluster sampling strategy. Results Among the 2680 couples reporting infertility, 1246 infertile couples consulted a fertility doctor. Age of the couple, man's body mass index and women's educational level were found to be associated with consultation behaviour. After the fertility work-up, diagnoses were tubal infertility ( n  = 353, 28.3%), unexplained infertility ( n  = 311, 25.0%), male infertility ( n  = 234, 18.8%), ovulatory disorder ( n  = 194, 15.6%) and endometriosis ( n  = 34, 2.7%), while 8.6% ( n  = 107) were not classified. Most couples received non-assisted reproductive technology (ART) fertility treatment ( n  = 906, 89.3%), with a proportion using traditional Chinese medicine (TCM) ( n  = 298, 29.4%). Intrauterine insemination ( n  = 62, 6.1%) and IVF/intracytoplasmic sperm injection ( n  = 57, 5.6%) were less frequent. Medical treatment and outcomes among five subtypes of infertility were also reported: about 30% of couples with unexplained infertility ( n  = 94, 30.3%) or male infertility ( n  = 67, 29.0%) used TCM to treat infertility. Apart from patients with endometriosis, of whom 20.6% ( n  = 7) received ART, patients with other infertility subtypes rarely received ART. For subsequent fertility outcome, 94% of them did not achieve a pregnancy. Conclusion The prevalence of infertility in China is high, but the uptake of treatment is relatively low.