Global, Regional and National Burden of Infertility due to Endometriosis: Results From the Global Burden of Disease Study 2021 and Forecast to 2044

BJOG. 2025 Jun;132(7):944-960. doi: 10.1111/1471-0528.18108. Epub 2025 Feb 25.

Abstract

Objective: To analyse global prevalence data for infertility due to endometriosis from 1990 to 2021, emphasising health inequalities.

Design: Population-based study.

Setting: Data from the Global Burden of Disease (GBD) database.

Population: Individuals diagnosed with infertility due to endometriosis.

Methods: A statistical method was employed to evaluate changes in disease prevalence over time. We also analysed how disease prevalence varies by age, time period and birth cohort. A model was used to predict future trends. Additionally, we examined the relationship between prevalence and the socio-demographic index (SDI) levels across countries. Finally, we conducted a decomposition analysis to identify key factors driving changes and assessed health inequality.

Main outcome measures: The burden of infertility due to endometriosis.

Results: The global burden of infertility due to endometriosis in 2021 showed a downward trend, and the low SDI region had a notably higher burden. High risk was observed in the 25-29 age group in the age effects analysis. Period risks almost kept decreasing over these years, and for cohort effects, the later born individuals showed an overall lower risk than the earlier born individuals. Cross-country inequality analysis revealed significant disparities, with countries in lower SDI categories bearing a higher burden.

Conclusions: The global burden of infertility due to endometriosis has become a significant public health concern over recent decades. Governments should adapt prevention strategies to fit their specific national contexts.

Keywords: Global Burden of Disease; Sociodemographic Index; endometriosis; health inequality; infertility; prevalence.

MeSH terms

  • Adult
  • Endometriosis* / complications
  • Endometriosis* / epidemiology
  • Female
  • Forecasting
  • Global Burden of Disease* / trends
  • Global Health / statistics & numerical data
  • Health Status Disparities
  • Humans
  • Infertility, Female* / epidemiology
  • Infertility, Female* / etiology
  • Prevalence
  • Socioeconomic Factors
  • Young Adult