Infertility in Turkey: evidence from Turkey Demographic and Health Surveys 1993-2013

Melike Saraç, Hacettepe University
Ismet Koc, Hacettepe University

Reproductive health is a priority global health area. The target for MDG 5B is to provide universal access to reproductive health by 2015. One of the indicators for monitoring progress in reaching this target is inability to conceive after a prolonged period. This is a critical but much neglected aspect of reproductive health issues. Turkey is a country lays emphasis on infertility, especially after experiencing dramatic fertility decline in the last decades. This study aims to understand infertility trends in Turkey by using different approaches, namely DHS approach (among married women aged 15-49 and 25-49), constructed approach (among all women), and current duration approach (among all women). Furthermore, the determinants of infertility based on constructed approach were also investigated with logistic regression models. The data comes from the 1993, 1998, 2003, 2008 and 2013 demographic and health surveys. The findings put forward that the prevalence of infertility derived from DHS approach have increased in the period of 1993-2003 (from 1.9 percent to 2.4 percent), and then have decreased significantly in the period of 2003-2013 (from 2.4 percent to 2.0 percent). This decrease observed during 2003-2013 period appears to be related with the increase in the using assisted reproductive techniques from 1.9 percent to 4.1 percent in Turkey. Infertility based on constructed and current duration approaches have declined in 2003-2008 period (from 22.6 percent to 11.8 percent and from 4.2 percent to 3.9 percent respectively). These declines are mainly originated from the improvements in the maternal healthcare services. Preliminary findings of the logistic regression models pointed out that education of women and wealth index (p<0.01), health insurance and property ownership (p<0.05) are main determinants of infertility besides age, region, using assisted reproductive techniques and age at first marriage (p<0.01) and body mass index (p<0.05), in Turkey in the period of 2008-2013.