Factors Influencing Secondary Infertility: An Analysis of NFHS Data in India

Abstract Objective Secondary infertility has emerged as a significant reproductive health issue in India, attracting growing attention in recent years. Although not as widely discussed as other health concerns, its impact on women’s health and well-being is becoming increasingly recognized. This study aimed to examine the trends in secondary infertility and identify the socio-demographic, health-related, and behavioural factors associated with the condition, also examines regional variation or heterogeneity in secondary infertility of women across the states of India using data from the National Family Health Survey (NFHS-5, 2019–21). Methods Using a large dataset from the NFHS-5, which included data from over 600,000 women of reproductive age, the study applied bivariate and multivariable logistic regression analyses to assess the association between secondary infertility and various predictors, such as age at marriage, educational level, socioeconomic status, health conditions (e.g., thyroid disorders, obesity), and lifestyle factors (e.g., smoking, alcohol consumption). The findings revealed that while the prevalence of secondary infertility showed a slight increase from 27% in 2015–16 to 28% in 2019–21. Result Key factors contributing to an increased risk of secondary infertility included delayed marriage, particularly after the age of 35, lower educational levels, and health conditions such as thyroid disorders. Lifestyle factors, including smoking, alcohol consumption, and obesity, were also significant contributors. Furthermore, women in southern states exhibited higher infertility rates compared to those in northern states, highlighting regional disparities in infertility prevalence. Conclusion In conclusion, while secondary infertility remains a relatively less common issue, its rising prevalence and the associated social and emotional challenges for women call for targeted interventions. The study’s findings provide valuable insights for policymakers to address the socio-demographic and behavioural factors contributing to infertility, ultimately improving reproductive health outcomes in India.