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

Qing Yan, H. Liu, Fei Liu, Jing Wei, Jia Wei, Tao Xiang, W. Ren, Wei Wang, Wen-wen Wang
In: Reproductive and Developmental Medicine · 2026 · doi:10.1097/rd9.0000000000000160 · W7138923592
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From 1990 to 2021, endometriosis-related infertility prevalent cases rose globally by 9.1% while age-standardized prevalence rates declined, with varying trends across regions and age groups.

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This study utilized data from the Global Burden of Disease Study 2021 to analyze trends in endometriosis-related infertility among women of reproductive age from 1990 to 2021. The analysis revealed that while the absolute number of prevalent cases increased by 9.1%, both all-age and age-standardized prevalence rates declined significantly by approximately 29%. These findings indicate a net annual decrease in prevalence, with variations observed across different Socio-demographic Index regions and younger cohorts. This paper is centrally about endometriosis — specifically quantifying the global burden and temporal trends of infertility caused by the condition.

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Abstract

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.
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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.

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