Levels, Trends and Determinants of Infertility in South Indian States

N Kavitha; Mr. N. Raja Kumar

Levels, Trends and Determinants of Infertility in South Indian States

Author(s)	Dr. N Kavitha, Mr. N. Raja Kumar
Country	India
Abstract	Introduction Infertility is becoming an important public health issue around the world but is often not gained attention. Though consequences of infertility are a cause for concern, efforts are made to reduce the total fertility rate while care for infertility received less attention. According to WHO, approximately one in six people have experienced infertility at some stage in their lives. It is argued that increase in infertility rates may be a factor responsible for reducing fertility rates in India. It is also found that women from states with lower Total Fertility Rate (TFRs) levels reported higher infertility as compared to women from states with a high level of TFR, which indicates increasing infertility is contributing to the declining fertility in India. Analysis of NFHS data at the state level revealed that primary infertility has shown a remarkable increase, especially in the southern states of India. Objectives of the Study 1. To understand the levels and trends in infertility in Southern states of India 2. To examine the determinants of infertility in Southern states Data and Methods Data from the five rounds of National Family Health Survey is used to understand the levels and trends in infertility in southern states of India over time. For further analysis, data from the fifth round of NFHS is used. At first, the analysis is carried out to understand the levels of primary infertility, childlessness and secondary infertility for states of India. In the next step, an attempt is made to understand the trends in primary infertility, childlessness and secondary infertility for southern states, namely, Andhra Pradesh, Karnataka, Kerala, Tamil Nadu and Telangana. Infertility by duration of marriage is found at the third stage. Subsequently, association between socioeconomic factors and child marriages is analyzed. An attempt is also made to understand the factors contributing to the prevalence of primary infertility and childlessness for in southern states of India. Women in the age group 15-19 are excluded in the analysis in order to avoid the effect of adolescent sterility. Similarly, women who are married within 5 years of the survey are also excluded as these women are not considered in the definition of infertility and childlessness. Results Primary infertility and childlessness are higher in some of the states viz., Andhra Pradesh, Chhattisgarh, Karnataka, Kerala, Maharashtra, Tamil Nadu and Telangana than other states. Secondary infertility is higher in the states of Andhra Pradesh, Kerala, Tamil Nadu and Telangana. Southern region is having higher levels of infertility as compared to other regions. Decreasing trend is noticed in the case of primary infertility in southern states from 1992-93 to 2015-16, increasing trend is noticed in all the southern states between 2015-06 and 2019-21 except Karnataka. There is notable increase in primary infertility in the states of Andhra Pradesh and Telangana. Similar pattern is observed in the case of childlessness in all the southern states. Secondary infertility levels do not change much between 1992-93 and 2019-21 in southern states except Kerala. In Kerala secondary fertility level has increased from 0.9 to 1.6. The burden of primary infertility significantly reduced within the first three years of marriage. However, the decline in primary infertility is very minimal after three years of duration of marriage for all the southern states. Logistic regression results show that age as a significant predictor for all three forms of infertility under consideration. Women in the age group 40-49 have higher likelihood for primary infertility, childlessness and secondary infertility than women in the age group 20-29. Women belonging to “Christian and others” religion have higher risk of primary infertility and childlessness as compared to Hindu women. Every increase in household wealth quintile and educational level of women decreased the likelihood of primary infertility and childlessness. It is interesting to note that odds of being infertile are higher among women who are overweight/ obese then among women have normal weight. Prevalence of diabetes appears to be a significant predictor for secondary infertility. Women who got married in the age group 20-24 and 25 and above found to have high risk for all forms of infertility. Using unsafe cooking fuel too showed a significant effect on the infertility.
Keywords	primary infertility. infertility, childlessness, South India, NFHS
Published In	Volume 8, Issue 4, July-August 2026
Published On	2026-08-01

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Levels, Trends and Determinants of Infertility in South Indian States

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