Sociodemographic and Health Factors Associated With Infertility Among U.S. Women: 2022-2023 National Survey of Family Growth Data

Objective: This study aims to assess the various sociodemographic and health-related factors associated with infertility among women in the United States using a nationally representative dataset. Design: This is a cross-sectional study utilizing data from the 2022-2023 National Survey of Family Growth. Materials and Methods: A cross-sectional analysis of women aged 15-49 years using data from the 2022–2023 National Survey of Family Growth (NSFG) was conducted. Infertility was defined as reporting attempts to conceive for 12 months or longer. Survey-weighted logistic regression models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association between covariates and infertility. Results: A total of 5,586 women participated in the 2022–2023 National Survey of Family Growth. After excluding respondents with missing or inapplicable data, 3,954 women were included in the primary regression analysis. Among these, 186 women (4.7%) reported attempting to conceive for 12 months or longer and were classified as infertile. Women who reported infertility were more likely to be married (71%), to have higher body mass index (41% for BMI >=30), and to report prior pregnancy loss compared with women who did not report infertility. Increasing age was associated with lower odds of reported infertility (adjusted odds ratio [aOR] 0.94 per year, 95% CI 0.91–0.97), likely due to differences in pregnancy intent across age groups. Women with obesity had significantly higher odds of infertility (aOR 2.61, 95% CI 1.46–4.67). Race/ethnicity, health behaviors (i.e. smoking, alcohol use, marijuana use), and insurance status were not independently associated with infertility. Women with a history of pregnancy loss had higher overall odds of infertility. However, pregnancy loss did not significantly modify the association between BMI and infertility. In a sensitivity analysis defining infertility more stringently as attempting pregnancy for at least 12 months and having sought medical care to become pregnant, 82 women met the medical care-seeking infertility definition. The associations were consistent in direction with the primary analysis. Conclusion: In this nationally representative survey data, obesity, age, marital status, and pregnancy loss history were associated with infertility among U.S. women, while health behaviors were not. These findings emphasize the importance of considering social and reproductive history factors when evaluating infertility risk and underscore obesity as a potentially modifiable risk factor.