Are fertility problems the inevitable fallout of the USA's older marriage ages? No, suggest new federal data released Wednesday that show infertility has actually declined.
"When you look at this downward trend, it goes against the popular wisdom of people we all know," says the report's lead author, Anjani Chandra, a health scientist at the National Center for Health Statistics.
Data show the percentage of married women ages 15-44 who were infertile fell from 8.5% in 1982 to 6% from 2006 to 2010. The actual numbers represent a drop from 2.4 million women to 1.5 million. For unmarried women living with a male partner, the new data show 4.9% as infertile.
Today's median age at first marriage is the highest ever: 26.6 for women and 28.6 for men, according to 2012 data from the U.S. Census.
Infertility, according to the agency's definition, is "lack of pregnancy in the 12 months prior to the survey, despite having had unprotected sexual intercourse in each of those months with the same husband or partner."
"People seem to think it's going up, when the fact is that it's remarkably stable, despite the preponderance of medical services," Chandra says. "The level of infertility is being counteracted by their pursuit of medical help to have a child. Both together are bringing down the percentage we see as infertile when we do our survey."
The report is based on 22,682 face-to-face interviews, including 12,279 women and 10,403 men.
Another measure called "impaired fecundity" is "physical difficulty in either getting pregnant or carrying a pregnancy to live birth." For married women of those ages, impaired fecundity was 12% in the latest data.
Physician Richard Reindollar, president-elect of the American Society for Reproductive Medicine, says his organization finds the new data encouraging.
"Even though the ages at which women in the United States have their children have been increasing since 1995, the percentage of the population suffering from infertility or impaired fecundity has not increased," says Reindollar, of Dartmouth College in Hanover, N.H.
Rafat Abbasi, a reproductive endocrinology physician in Bethesda, Md., says the time period in which the survey was conducted may well play a role in the data's recent stability.
"People were getting older - beyond the scope of fertility treatments," she says. "And the second thing is the economic recession, when a lot of people couldn't afford to do these treatments. I don't think it was due to more fertile people being around. It's more a factor of these coexisting conditions."
Both Abbasi and Chandra say the definition of infertility may affect the data. Chandra speculates that some - such as a woman over 35 - may not wait 12 months for medical intervention, which means she wouldn't meet the report's definition for being infertile.
However, Barbara Collura, executive director of RESOLVE: The National Infertility Association, a non-profit based in McLean, Va., says she doesn't think people are seeking help sooner. "I'm very frustrated that people wait too long to see a specialist. I hear it anecdotally over and over."
Chandra says the single most important factor associated with fertility problems is the age at which a woman tries to have her first child. The drop from 44% to 27% for infertility from 1982 to 2006-10 for women ages 35-44 is due to both the likelihood of medical treatment as well as the smaller pool of people trying to become pregnant at those ages, she says.
Collura says it's unclear what to make of the new federal data.
"We have more people seeking our services and being part of our community than ever before," she says. "Does that mean there are more people with infertility? Not necessarily."
A barrier to treatment is cost, she says, citing an online survey her organization conducted last month of 1,694 individuals. The not-yet-released data show that 60% of respondents have little to no insurance coverage for infertility treatment.
In addition to testing, which can cost up to $1,500, treatments vary depending upon the services needed. Costs can reach tens of thousands of dollars per treatment, Abbasi says.
Sharon Jayson, USA TODAY