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American Journal of Epidemiology Vol. 130, No. 2: 259-267
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health


research-article

RESEARCH ON INFERTILITY: DEFINITION MAKES A DIFFERENCE

POLLY A. MARCHBANKS1,2, HERBERT B. PETERSON1, GEORGE L. RUBIN1, PHYLLIS A. WINGO1 and THE CANCER AND STEROID HORMONE STUDY GROUP1

1From theDivision of Reproductive Health, Center for Health Promotion and Education, Centers for Disease Control Atlanta, GA 30333
2Current Adress: Division of Injury Epidemiology and Control, Center for Environmental Health and Injury Control, Centers for Disease Control Atlanta, GA 30333
3Department of Pathology, University of Utah School of Medicine Salt Lake City, UT
4Department of preventive Medicine and Biometrics Uniformed Services, University of the Health Sciences Bethesda, MD

Although different definitions of infertility are used, research findings based on various definitions have not been systematically compared. To contrast the impact of five definitions of infertility on research findings, the authors analyzed data from the control group (randomly selected US women aged 20–54 years) of the Cancer and Steroid Hormone Study (1980–1983). For all definitions, an absence of recognized conception was the outcome of interest Specifically, the authors examined the effect of various definitions of infertility on demographic characteristics of women classified as infertile, prevalence of a history of infertility, age at infertility classification, and cumulative incidence of conception after infertility classification. Results indicated that women classified as infertile by definitions based on unprotected intercourse for 12 months and unprotected intercourse for 24 months were more likely to be black, less educated, and classified as infertile at younger or older ages than women classified by alternative definitions. The prevalence of a history of infertility ranged from 6.1% {physician diagnosis) to 32.6% {unprotected intercourse for 12 months). For the definitions based on unprotected Intercourse for 12/24 months and for physician diagnosis, the cumulative incidence of conception by > 120 months after infertility classification was 86.3%, 76.7%, and 75.4%, respectively. The authors conclude that the definition of infertility has an impact on research findings related to which and how many women are classified as infertile, the age at infertility classification, and the probability of future conception.

infertility; reproduction; women


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