Infertility Burden and Costs in Iran: A Mixed-Methods Study Using GBD and Local Insights (2022–2023)

Document Type : Original Article

Authors

Department of Healthcare Services Management, School of Health, Zabol University of Medical Sciences, Zabol, Iran

Abstract

Introduction: Infertility poses significant health and economic challenges in Iran, yet regional burdens remain underexplored. This study estimates infertility prevalence, Disability-Adjusted Life Years (DALYs), and outpatient costs in Iran for 2022–2023, integrating Global Burden of Disease (GBD) 2021 data with local perspectives through sensitivity scenario analyses.
Methods: A convergent parallel mixed-methods design combined unadjusted GBD 2021 quantitative estimates with scenario-based sensitivity analyses for regional contextual factors (e.g., healthcare access, environmental stressors), alongside semi-structured interviews from 10 stakeholders (5 providers, 5 patients) in Sistan, integrated via joint display and thematic analysis. Costs were sourced from national studies and adjusted for inflation.
Results: Unadjusted lifetime infertility prevalence was estimated at 11.8% (95% CI: 11.2–12.4) in 2022 and 12.0% (95% CI: 11.4–12.6) in 2023. Under sensitivity scenarios, prevalence ranged up to 12.9% in underserved areas. Unadjusted DALYs increased from 17.4 to 18.1 per 1,000 (P = 0.04), with women at higher burden. Costs grew 9.7% (absolute increase of $60, from $620 to $680 per cycle, P = 0.01), with 65% out-of-pocket. Qualitative interviews highlighted financial strain, access barriers, stigma, and emotional distress.
Conclusion: Infertility in Iran reflects a persistently high epidemiological and economic burden. The mixed-methods approach, incorporating sensitivity analyses, offers a scalable model for burden estimation in data-scarce settings, informing policy reforms.

Highlights

Fatemeh Mohabati: Google Scholar

Seyed Pouria Hedayati: Google Scholar

 

Keywords

Main Subjects

References

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Health Management & Information Science
Volume 13, Issue 2
April 2026
Pages 154-161

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