The healthcare system of some Canadian provinces assumes expenses for infertility clinic services and assisted reproductive technologies while all provinces bear the healthcare costs of preterm and multiple births, which often result from fertility treatments. How common infertility is has important implications for both healthcare services and costs.

Data collected by a Canadian Community Health Survey (CCHS) show that in 2009-2010 there were about 3.2 million married plus common-law couples in Canada, with the partners living together for at least 12 months, and with the female partner aged between 18 and 44 years old.

Among these couples, 70% had at least one child, and 99% reported having had sexual intercourse during the previous 12 months, also, 76% of them used some form of birth control.

A 2012 report on the prevalence of infertility, the first significant one for Canada since 1993, is based on the same CCHS survey with data collected from a subset of 5,617 individual participants who were married or living common-law in the 12 months prior to being surveyed.

Prevalence

Couples were categorized as “currently infertile” (as opposed to “long-term infertility”) if there was no pregnancy in the 12 months prior to the survey and during which time no contraception was used.

Results for the 2009-2019 survey showed that about 16% of couples were currently infertile, much higher than the 5.4% in 1984 and 8.5% in 1992, indicating a significant increase. By comparison, estimates of infertility in other industrialized countries range from 10 - 15% but these estimates are not necessarily based on the same criteria as in this study.

This study also showed that increased age of the female, but not the male, was related to increased infertility.

Compared with data from earlier studies, current infertility prevalence shows an increase: among couples with the woman 40-44 years of age, it was 4.6% in 1984 and about 20% in 2009-2010; among couples with the female aged 18-29, the prevalence was 4.9% in 1984 and in 2008-2009 it was about 14%.

In general, couples with fewer than 2 children had a higher prevalence of current infertility than those with 2 or more .

Why prevalence increased

What might account for the increase in prevalence of current infertility in Canada?

One factor is age of the female. As this study (and others in various countries) shows, female age is a risk factor for infertility, and Canadian statistics show that in recent years more women are having their first child at a later age than before. The percentage of first children born to women aged 35 or older in 1984 was 3%, and in 2008 it was 11%.

Other factors affecting fertility such as smoking, obesity, alcohol use and sexually transmitted infections also play roles. But these roles have not been fully characterized yet.