Global, Regional, and National Burden of Endometriosis-Related Infertility in Women of Reproductive Age: Analysis Based on the Global Burden of Disease Study 2021

Objective: To assess the global, regional, and national burden and trends of endometriosis-related infertility in women of reproductive age. Methods: Data were extracted from the Global Burden of Disease Study 2021. We analyzed the number of cases, all-age and age-standardized prevalence rates, and relative changes globally, regionally, and nationally, stratified by age and Socio-demographic Index (SDI) quintiles. An age-period-cohort model was used to estimate net drifts, local drifts, and period/cohort-specific relative risks from 1990 to 2021. Results: From 1990 to 2021, prevalent cases increased by 9.1% (1.09 million to 1.19 million). Global all-age prevalence rate decreased by 29.07% (42.52 to 30.16 per 100,000), and age-standardized prevalence rate decreased by 28.38% (41.89 to 30.00 per 100,000). The annual net drift was -1.03%, ranging from -1.58% in low SDI regions to -0.68% in high SDI regions. Age distribution transitions were observed in high, high-middle, and middle SDI regions. Relative risks declined over time and across younger cohorts, except in high SDI regions after 2000. Conclusions: Endometriosis-related infertility reflects endometriosis prevention and treatment trends. The increasing number of cases alongside declining prevalence rates highlights the need for targeted interventions to reduce the global burden.