JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):94
Poster Presentation
29th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263681
P-82. Epidemiological Analysis of the Prevalence of Infertility and Infertility-Associated Gynecological Diseases in Brazil (2015–2024)
Priscila Luiza dos Santos1, Ana Clara Pimenta Servidoni2, Giovanna de Castro Martin1, Katherine Ann Reimão Miller3, Leticia Souza Santos1, Marina de Paula Andres4, Maurício Simões Abrão5
1 Faculdade Santa Marcelina - São Paulo - SP - Brasil
2 Yale School of Medicine - São Paulo - SP - Brasil
3 Universidade de Santo Amaro - São Paulo - SP - Brasil
4 Beneficência Portuguesa de São Paulo - São Paulo - SP - Brasil
5 Universidade de São Paulo - São Paulo - SP - Brasil
Objective: To investigate the prevalence and regional distribution of female infertility and associated gynecological diseases in Brazil between 2015 and 2024, and to assess their correlations through hospital admission data from the public healthcare system.
Methods: An ecological, descriptive study was conducted using the Hospital Morbidity Database (SIH/SUS) of DATASUS. Women aged 20–49 years were included. Cases were identified by ICD-10 codes for infertility (N97), endometriosis (N80), leiomyoma (D25), menstrual disorders (N91–N94), non-inflammatory ovarian/tubal disorders (N83), cervicitis (N72), other pelvic inflammatory diseases (N73), and salpingitis/oophoritis (N70). Data were stratified by Brazil's five regions and analyzed from January 2015 to December 2024. Descriptive statistics were expressed as counts and proportions. Correlations between infertility and each condition were tested using Spearman's coefficient (ρ).
Results: A total of 5,151 admissions for female infertility were recorded. The Southeast accounted for the largest share (2,612; ~51%), followed by the Northeast (1,477; ~29%), South (674; ~13%), Center-West (213; ~4%), and North (175; ~3%). Endometriosis totaled 92,637 admissions, highest in the Southeast (38,738; ~42%) and Northeast (24,396; ~26%). Leiomyoma presented the greatest overall burden (669,855 admissions), especially in the Northeast (288,472; ~43%) and Southeast (206,868; ~31%). Menstrual disorders (21,993 admissions) were concentrated in the Southeast (~51%). Non-inflammatory ovarian/tubal disorders (152,197 admissions) showed similar prevalence in the Southeast and Northeast (both ~34%). Other pelvic inflammatory diseases (138,952 admissions) and salpingitis/oophoritis (101,323 admissions) predominated in the Northeast (~29% and ~46%) and Southeast (~35% and ~24%). Correlation analysis showed endometriosis had a perfect positive correlation with infertility (ρ=1.0). Strong correlations were observed for menstrual disorders (ρ=0.8) and other pelvic inflammatory diseases (ρ=0.7). Moderate correlations were found for ovarian/ tubal disorders, salpingitis/oophoritis, and leiomyoma (all ρ≈0.6), and cervicitis (ρ=0.5).
Conclusion: Female infertility admissions are unevenly distributed in Brazil, with the Southeast and Northeast most affected. Endometriosis not only ranks among the leading associated conditions but also shows perfect regional correlation with infertility, underscoring its role in the infertility burden. Strong associations with menstrual and pelvic inflammatory disorders point to priorities for prevention and early diagnosis. Regional differences likely reflect both true variation in incidence and disparities in diagnostic capacity, surgical access, and healthcare-seeking behavior. The predominance of diagnoses in higher-resource regions suggests underdiagnosis in underserved areas, particularly in the North and Center-West. These findings reinforce the need for region-specific reproductive health strategies, including expanded diagnostic capacity, earlier detection of endometriosis and pelvic infections, and equitable access to infertility care nationwide.