The epidemiology of infertility in a rural population.

Background: To study the prevalence of infertility, outcome of pregnancy, and uptake of medical services in a rural population.

Methods: 1000 women aged 45-54 years, randomly selected from the Shropshire FHSA primary care register were sent a postal questionnaire.

Outcome Measures: Response rate, time to pregnancy, pregnancy outcome, medical advice sought, diagnoses, and any treatments.

Results: Of the initial one thousand women, two had to be excluded by age and 142 women were excluded because of wrong address. A total of 728 completed questionnaires were returned leading to a response rate of 85.0%. A total of 74.6% women reported no infertility and 8.1% women were voluntarily sterile. The prevalence of infertility at 12 months was 17.3% and 12.0% at 24 months. The prevalence of primary infertility was 10.6%, of whom 77.9% eventually conceived, and 6.7% had secondary infertility, of whom 71.4% eventually conceived. There were a total of 1680 pregnancies, of which 8.6% ended in spontaneous abortion. The highest proportion of spontaneous abortions (11.4%) was amongst women who had experienced primary infertility. Of all infertile women 51.6% did not seek any advice or treatment and only 34.1% attended for hospital appointments. Ovulatory disorder was the commonest diagnosis. There appeared no association between occupation and infertility, outcome of pregnancy, or uptake of services.

Conclusion: These findings are similar to other epidemiological studies, although in this population the uptake of medical services is low.