A survey of infertility, surgical sterility and associated reproductive disability in Perth, Western Australia

Infertility, surgical sterility and associated reproductive disability were studied in a stratified cluster sample of 1,511 couples with women aged 16 to 44 years resident in metropolitan Perth in 1988. Sixteen couples were omitted from analysis because of missing data. The proportion of couples affected by current infertility was 3.5 per cent (53 of 1,495), and 67.9 per cent of these (36 of 53) had a reproductive disability, meaning that they were unable to achieve their desired level of reproductive function. Those affected by surgical sterility accounted for 37.1 per cent (555 of 1,495), and of these couples 2.0 per cent (11 of 555) had a reproductive disability. Empirically, the prevalence of both infertility and reproductive disability peaked at ages 30 to 34 years in the female partner. Of the factors studied, infertility was associated with surgery for a ruptured appendix, a history of pelvic inflammatory disease and number of sexual partners. In 10 of the 47 couples with reproductive disability, contraceptive sterilisation had been a cause of later regret. Most other cases were due to infertility. Almost one half of couples with reproductive disability had sought treatment. The affected couples had at least one child from the current union in 23 of the 47 cases of reproductive disability. The results support the need for development of a strategy to prevent infertility and other causes of reproductive disability.

PIP: In September-December 1988 in Australia, at least 1495 couples in metropolitan Perth completed a questionnaire as a part of a study to measure the extent of infertility (inability to conceive after 12 months on unprotected intercourse) and sterility (surgical procedure responsible for end of reproductive function) and to examine their characteristics and associations. 22.6% of all couples had no children. 53 couples (3.5%) suffered from current infertility. It was highest among 30-34 year old women (4.2%). 285 women (19.1%) had experienced infertility at some time in their lives. Lifetime cumulative incidence of ever having been infertile was 22.8%. Lifetime infertility was significantly associated with multiple sexual partners (p = .04), pelvic inflammatory disease (p = .0001), and appendicitis with rupture (p .0001). Tubal pathology and male problems were the leading causes of infertility. 555 couples (37.1%) experienced surgical sterility. Just 2% of these 555 couples had an associated reproductive disability (inability to achieve desired level of reproductive function). Sterility prevalence was greatest among 40-44 year old women (72.2%). Contraceptive sterilization was the major reason for surgical sterility. 47 couples (3.1%) had reproductive disability. They comprised 36 infertile couples and 11 surgically sterile couples. 10 of the surgically sterile couples regretted their decision to undergo sterilization. 48.9% of all reproductive disabled couples had at least 1 child. 23 of the 47 couples sought medical treatment for reproductive disability. Reproductive disability peaked at 30-34 years old (female partner's age). Medical intervention allowed .9% of all women (14 women) in the survey to conceive. These results indicated a need to develop a strategy to prevent reproductive disability, especially infertility.