Self-reported fertility problems and their socio-demographic and health correlates: a cross-sectional online survey of 8000 Polish adults

While biological and lifestyle determinants of reproductive health are well documented globally, comprehensive data integrating socio-demographic, lifestyle, and health correlates within a contemporary Polish context remain limited. This study aimed to estimate the prevalence and identify correlates of self-reported fertility problems among adults completing a 2024 online survey in Poland (the National Fertility Test). Of the 8,000 respondents surveyed, the analytical sample comprised 5,532 (3,316 women, 2,216 men) who had attempted to conceive. Sex-specific, age-adjusted, Holm-Bonferroni-corrected logistic regression assessed associations between socio-demographic, lifestyle, and health variables and fertility problems. Within the analytical sample, 28.9% of respondents reported fertility problems (36.6% of women and 17.4% of men). Among women, the strongest associations were observed for Fallopian tube obstruction (OR = 23.0), polycystic ovary syndrome (OR = 5.35) and endometriosis (OR = 2.82), whereas a history of prior pregnancy (OR = 0.26) and better self-rated mental health (OR = 0.76) were associated with lower odds. Among men, associations were limited to use of reproductive supplements (OR = 4.06), varicocele or epididymal cysts (OR = 3.08), and a history of sexually transmitted infection (OR = 4.60). In both sexes, associations with behaviours such as supplement use and specific conception strategies likely reflect reverse causation, marking active help-seeking rather than causal risk factors. Given the self-selected sampling method, these findings should not be interpreted as population-level prevalence estimates for Poland, but confirm established clinical correlates alongside distinct socio-demographic and lifestyle patterns, underscoring the need for targeted reproductive health education. Lay Summary This study examined the frequency of fertility struggles among 8,000 Polish adults through the 2024 National Fertility Test, a nationwide online survey. Among the 5,532 participants who had attempted to conceive, 28.9% reported such difficulties. Factors linked to these struggles differed by sex. ● For women: conditions such as Fallopian tube obstruction, polycystic ovary syndrome (PCOS), thyroid disease, or endometriosis were among the strongest factors; a history of prior pregnancy and better self-reported mental health were both linked to lower odds of reporting current problems. ● For men: varicocele or epididymal cysts, and a history of sexually transmitted infection were the clearest factors identified. Due to the self-selected online nature of this cohort, results likely reflect participation bias from people currently attempting to conceive. Overall, the study underscores significant reproductive challenges in Poland, highlighting a strong, critical need for better health education and support tailored specifically to the Polish public.