Infertility prevalence, needs assessment and purchasing.

A postal questionnaire was used to assess the prevalence of primary and secondary infertility in Somerset. Three age groups of women were surveyed: those aged 36-40 (n = 965), 41-45 (n = 1115) and 46-50 years (n = 1061). Using these three age groups, most of whom had completed their reproductive lifespan, time trends both in the prevalence of infertility and service use were obtained. A 75.7 per cent response rate was achieved. No trends towards increasing prevalence of infertility were seen, but greater use was made of services in the younger age group. The overall prevalence of primary infertility was 16.1 per cent (95 per cent confidence interval (Cl) 14.6-17.6) if failure to conceive after one year is used as the definition of infertility. Similarly, the prevalence of secondary infertility was 15.8 per cent. It was found that 26.4 per cent (95 per cent Cl 24.6-28.2) of women were likely to suffer from infertility at some time and only 3.0 per cent of women were involuntarily childless. Twenty-five women (1.1 per cent) suffered recurrent miscarriages. There was no change in the likelihood of conception in the three age groups of women suffering infertility. Those in lower socio-economic groups were less likely to consult their general practitioners (GPs) when difficulties in conceiving were experienced. Examinations of a sample of responders' and non-responders' medical records suggested that the use of postal questionnaires in assessing the prevalence of infertility may, to some extent, be prone to bias.(ABSTRACT TRUNCATED AT 250 WORDS)