The epidemiology of infertility in a rural population

Background To study the prevalence of infertility, outcome of pregnancy, and uptake of medical services in a rural population. Methods. 1000 women aged 45-54 years, randomly selected from the Shropshire FHSA primary care register were sent a postal questionnaire. Outcome Measures. Response rate, time to pregnancy, pregnancy outcome, medical advice sought, diagnoses, and any treatments. Results. Of the initial one thousand women, two had to be excluded by age and 142 women were excluded because of wrong address. A total of 728 completed questionnaires were returned leading to a response rate of 85.0%. A total of 74.6% women reported no infertility and 8.1% women were voluntarily sterile. The prevalence of infertility at 12 months was 17.3% and 12.0% at 24 months. The prevalence of primary infertility was 10.6%, of whom 77.9% eventually conceived, and 6.7% had secondary infertility, of whom 71.4% eventually conceived. There were a total of 1680 pregnancies, of which 8.6% ended in spontaneous abortion. The highest proportion of spontaneous abortions (11.4%) was amongst women who had experienced primary infertility. Of all infertile women 51.6% did not seek any advice or treatment and only 34.1% attended for hospital appointments. Ovulatory disorder was the commonest diagnosis. There appeared no association between occupation and infertility, outcome of pregnancy, or uptake of services. Conclusion. These findings are similar to other epidemiological studies, although in this population the uptake of medical services is low.