Infertility and subfecundity in population-based samples from Denmark, Germany, Italy, Poland and Spain

Background: No uniform data which give basic information on the societal burden of infertility and subfecundity exists in Europe. Methods: In a population based survey the prevalence of subfecundity was ascertained by means of a standardized interview with women in Denmark, Germany, Poland, Italy and Spain. The time of unprotected intercourse (TUI) either leading or not leading to pregnancy was applied as a uniform measure of fecundity. Population-based samples of women 25-44 years of age were recruited. Results: Altogether 6,630 women participated in the study. With regard to the first pregnancy, 19% of all couples had a TUI of more than 12 months, which is within the range of most previous findings. Regarding the most recent and first TUI in individual lives, if it had occurred within previous 5 years, 23.4% overall did not conceive within 12 months (in Poland 33.3%, in north Italy and Germany 26.2%, in Denmark 23.3%, in Spain 18.6% and in south Italy 14.8%). Secondary subfecundity was more prevalent in Poland. When stratifying for planning of a pregnancy, the differences between countries diminished, particularly for the most recent TUI. However, the pattern of a higher prevalence of subfecundity in Poland, north Italy, Denmark and Germany and a lower prevalence (<20%) in Spain and south Italy remains. Conclusions: Important differences in the prevalence of subfecundity exist between the six European regions investigated. Comparisons should first consider TUIs or planned TUIs to reduce the impact of distorting factors, which are mainly due to differing cultures of family planning in Europe.