Infertility trends in Canada ( ) Dr. Jocelynn Cook Chief Science Advisor Assisted Human Reproduction Canada

Transcription

1 Infertility trends in Canada ( ) Dr. Jocelynn Cook Chief Science Advisor Assisted Human Reproduction Canada

2 Infertility The use of AHR and associated technologies and procedures has been increasing over the years Studies suggest that this increase may be attributed to increased incidence of infertility Challenges with prevention and treatment of infertility and successful outcomes of AHR have roots in public health

3 Risk Factors for Infertility Risk factors for infertility include public health factors: Environmental contaminants Pharmaceuticals Smoking and alcohol use Obesity Chronic disease Sexually transmitted infections Delayed childbearing Outcomes associated with infertility treatment have public health implications

4 Total Fertility Rate, Canada,

5 Distribution of First Births, by Age of Mother, Canada, 1976 and 1996

6 The Canadian Community Health Survey Background The CCHS Infertility (INF) module represents first national-level data since the Canada Health Monitor and Decima surveys Analysis and dissemination of the CCHS INF module will help AHRC fulfill one of its responsibilities to:...become a centre of expertise on AHR by collecting and disseminating public information Report on Plans and Priorities for (ARHC)

7 Study Objectives To investigate whether the prevalence of infertility has changed with the trend to older parenthood To measure health and lifestyle factors associated with infertility

8 Live births per 1,000 females, Canada

9 Live births per 1,000 females, age 40+, Canada

10 Methods Data from the infertility module of Statistics Canada s Canadian Community Health Survey (CCHS) were analysed for the period of September to December 2009, and compared with similar data from the 2001 General Social Survey and the 1991/1992 Royal Commission on New Reproductive Technologies surveys. Infertility is measured as the failure to conceive after more than one year of not using birth control. The target population is women aged 18 to 44 who are married or living common-law. PRELIMINARY Data N=3,540 (expect final n=6,000)

11 Infertility indicators of interest 1. In past 12 months, absence of pregnancy in heterosexual couples who have cohabited during this period and have not used contraception (non-surgical or surgical) 2. Self-reported difficulty in conceiving 3. Experience of a period of at least 6 months of failure to conceive 4. Time to pregnancy for couples who have had at least one child

12 Infertility indicators: 12 month passive infertility 1. In past 12 months, absence of pregnancy in heterosexual couples who have cohabited during this period, and have not used contraception (non-surgical or surgical) Female partner is years old Female partner is years old Excluding surgical sterilization (Royal Commission) 2009 (Canadian Community Health Survey) 8.5% 17.8% % 15.4% 22.7%

13 Infertility Indicators: Self-perceived infertility 2. Self-reported difficulty in conceiving: Defined as during the time that you and your partner have been together, have you had any problems in conceiving a child and seen a doctor or other medical care provider about this? Female partner is years old Female partner is years old % tried to get pregnant with current partner Among those who tried to get pregnant, % trouble conceiving and seen a doctor 77.8% 77.7% 14.1% 14.0%

14 Infertility indicators: 6-month infertility 3. Experience of a period of at least 6 months of failure to conceive, among those who have tried to get pregnant with their current partner Female partner is years old Female partner is years old % tried to get pregnant with current partner Among those who tried to get pregnant, % experienced 6 months of no success 77.8% 77.7% 22.1% 21.4% 14

15 Infertility indicators of interest 4. Time to pregnancy for couples who have had at least one child According to the 2009 CCHS data: 31% of all couples had no children; 21% had one child; and 49% had two or more children Among couples (regardless of age of female partner) with at least one child: 92% had achieved their first pregnancy within 12 months of trying, 96% had achieved it within 24 months, and 97% had achieved it within 36 months 15

16 Weighted Cumulative Distribution of Time to 1 st Pregnancy in Months Weighted cumulative distribution of time to first pregnancy in months Percent Months

17 Preliminary data: Age distribution within each fertility category

18 Preliminary Data: Education

19 Preliminary Data: Lifestyle Factors Smoker in the house Female is a daily smoker Female is a regular drinker Female is obese or overweight

20 Preliminary Data: History of Sexually Transmitted Diseases

21 Comparison: 1990s-present year infertility 8.5% 17.8% Female smokers of reproductive age 29% 19.1% Overweight (females 18-44) 19.6% 29.6% Obese (females 18-44) 10.9% 19.8% Teen pregnancy/live birth 2.2% 1.1% Pregnancy after % 0.74%

22 Preliminary Results Provide a current measure of infertility in Canada, as well as changes in prevalence over an 18 yr period. Provide information about changes in infertility trends in Canada. Data to determine health and socio-demographic associations will be available for analysis in Fall Infertility is a key public health concern and challenge in Canada. Relevant and timely data on risk and prevalence is essential to formulate program and policy initiatives aimed at reducing the social, economic and health burdens of infertility.

23 Thank you