Abstract:
There are a number of reasons why epidemiological approaches to infertilityhave not made a major contribution to research in Australia. They include thesuccess of generic treatments, the high public profile of infertility and theconsequent polarization of discussion over treatment versus prevention, somereluctance to draw attention to possible aetiologic factors which may beperceived negatively in public debates, and the lack of graduate training inreproductive and perinatal epidemiology. Voluntary infertility is now commonfor most of the fertile life span in developed countries, and intended familysize is small. Many important conditions cannot be diagnosed without the useof invasive procedures or complex investigations, and the more widespread useof less invasive procedures has shown other conditions to be relatively commonin healthy populations. If epidemiological approaches are to make a greatercontribution towards an increased understanding and control of infertility,research should focus on retrospective and prospective cohort studies of theincidence and prevalence of infertility, nested case-control studies ofoccupational and environmental exposures, and an extension of the developinguse of record-linkage across routinely collected data systems and registers.