Modifiable socioeconomic and lifestyle risk factors for female infertility in Asia: a systematic review from the population health perspective

Abstract

Objective

To pinpoint the knowledge gaps and systematically identify modifiable infertility-related socioeconomic and lifestyle risk factors in Asian women, since most studies on female infertility-related risk factors were conducted in the Western populations. This review pinpointed the knowledge gaps and aimed to systematically identify modifiable infertility-related socioeconomic and lifestyle risk factors in Asian women.

Evidence Review

We performed a systematic literature search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist from January 1, 1990, to October 31, 2021, in PubMed, the Web of Science, Embase, and Scopus, using a set of keywords related to our schemes, such as socioeconomics, lifestyle, infertility, and time to pregnancy. We shortlisted a combination of available full texts, English publications, original research articles, human subjects, and nonpregnant women of childbearing age with the intent of conceiving without medical assistance as the population of interest for further screening.

Results

We included 43 Asian studies that reported modifiable socioeconomic and lifestyle risk factors with the following outcomes: time to pregnancy; pregnancy rate; or infertility rate. Similar to the Western populations, female infertility in Asian women was associated with advanced age at marriage, sexual dysfunction, elevated stress levels, and greater adiposity. Interestingly, a higher socioeconomic status in Asian women was positively associated with female infertility, whereas a higher socioeconomic status in their male partners was inversely associated with couple infertility. Regrettably, few publications reported lifestyle risk factors, such as physical activity, dietary food groups, sleep disorders, and substance use.

Conclusion

Asian women may have more infertility-related cultural and dietary diversity, and it is worthy of future research efforts. It is also critical and more effective to tackle the infertility problem in both women and men. Hence, we discussed the imperative need for research efforts in Asian couples.