Prevalence of primary infertility in China: In-depth analysis of infertility differentials in three minority province/autonomous regions

Following the 1994 UN International Conference on Population and Development, there was a shift in emphasis on women's reproductive health and there emerged a need for more knowledge about levels and differentials of infertility. Using the data from the 1988 National Two-Per-Thousand Sample Survey on Fertility and Contraception, this paper estimated the prevalence of primary infertility in China. To determine the predictors of primary infertility, multiple logistic regression analyses were done on three minority province/autonomous regions where primary infertility was the highest. A non-contracepting, sexually active woman was considered to have primary infertility if she had not reported a recognized pregnancy after at least seven years of marriage. The analysis shows that the national level of primary infertility was relatively low (1.3%). Primary infertility was higher in Qinghai (2.3%), Tibet (3.7%) and Xinjiang (3.7%) compared with other provinces. Tibetans in Qinghai and Uygurs in Xinjiang had a higher level of primary infertility than the Han Chinese. Ethnic differences remained after adjusting for other background characteristics. Divorced and remarried women had significantly higher odds of primary infertility compared with first-married women in Qinghai and Xinjiang. The elevated level of primary infertility in Qinghai, Tibet and Xinjiang and its disproportionate prevalence among Tibetans and Uygurs highlight the need for further work to understand the causes and social consequences of infertility for the minority population in China.