Background and Objective: Infertility is a major challenge in reproductive health with biological, psychological, and social consequences. Despite the importance of sex-based differences, national evidence based on standardized data is limited in Iran. This study aimed to investigate sex-based differences in the epidemiological pattern of infertility in Iran based on data from the Global Burden of Disease (GBD) study for the year 2023.
Methods: This study is a descriptive cross-sectional study based on a secondary analysis of GBD data. Indicators of prevalence, disability burden, primary and secondary infertility, age groups, and causes of infertility were examined by sex, and differences were calculated using absolute differences and the female-to-male ratio.
Results: The prevalence and disability burden of infertility in women are approximately twice those in men. The female-male difference increases with age; the ratio of infertility rates in women to men rises from 1.5 at the beginning of reproductive age to 2.9 at the end of reproductive age. Non-communicable diseases are the most important cause in both sexes, but the pattern of causes differs; gynecological diseases in women and urinary tract diseases and male infertility in men account for the largest proportions.
Conclusion: Infertility in Iran has a distinct sex-based pattern, and women have a more unfavorable status across all indicators. The widening gap with increasing age and differences in causes emphasize the necessity of designing prevention, diagnosis, and treatment programs with a gender-oriented approach. These findings can serve as a basis for evidence-based policymaking in the country's reproductive health.