Impaired fecundity in the United States: 1982-1995.

CONTEXT: The 1995 National Survey of Family Growth (NSFG) provides new nationally representative data to test the accuracy of the commonly held assumption that impaired fecundity has been rising in the United States over the past decade.
METHODS: Using data from the 1982, 1988 and 1995 rounds of the NSFG, trends in both the proportions and numbers of women with impaired fecundity and of those who received infertility services were examined. Multiple logistic regressions were carried out to estimate the effects of demographic characteristics on the likelihood of currently having impaired fecundity and of ever having received medical help for infertility.
RESULTS: The proportion of U.S. women aged 15-44 who reported some form of fecundity impairment rose from 8% in 1982 and 1988 to 10% in 1995, an increase in absolute numbers from 4.6 million to 6.2 million women. Although the proportion of fecundity-impaired women who had ever sought medical help did not change between 1988 and 1995 (44%), the absolute numbers of such women grew by nearly 30%, from 2.1 million to 2.7 million. Women who had ever sought help for fertility problems were older and had a higher income than those who had not, and were more likely to be married.
CONCLUSION: The dramatic increase in the numbers of U.S. women with impaired fecundity occurred because the large baby-boom cohort, many of whom delayed childbearing, had reached their later and less fecund reproductive years. This increase in both rates and numbers occurred across almost all age, parity, marital status, education, income, and race and ethnicity subgroups.