How Late Can You Wait? Measurement Challenges and Health Concerns Related to Infertility and Delayed Childbearing

Anjani Chandra, National Center for Health Statistics, Centers for Disease Control and Prevention
Elizabeth H. Stephen, Georgetown University
Dik Habbema, Erasmus University
Egbert R. te Velde, Utrecht University

Periodic national fertility surveys in the United States have produced standard measures of reproductive behavior so that trends such as delayed childbearing can be identified and prevalence of conditions such as infertility can be measured over time. Standard measures, however, bring methodological challenges. This paper examines the difficulties in measuring infertility on a population level consistently and accurately over time. We focus on two measures, 12-month infertility and impaired fecundity, in an attempt to better understand the sometimes conflicting messages about prevalence of infertility from various data sources. We also discuss these measures of infertility in the context of health concerns confronting women who delay childbearing and perhaps pursue infertility treatment. These concerns, which include increased risk of multiple births, low birthweight, and birth defects, are in excess of the challenges of getting and staying pregnant, and should be included in any assessment of how late women can wait.