Modifiable socioeconomic and lifestyle risk factors for female infertility in Asia: a systematic review from the population health perspective

Objective:To pinpoint the knowledge gaps and systematically identify modifiable infertility-related socioeconomic and lifestyle riskfactors in Asian women, since most studies on female infertility-related risk factors were conducted in the Western populations. Thisreview pinpointed the knowledge gaps and aimed to systematically identify modifiable infertility-related socioeconomic and lifestylerisk factors in Asian women. Evidence Review:We performed a systematic literature search according to the Preferred Reporting Items for Systematic Reviews andMeta-Analyses checklist from January 1, 1990, to October 31, 2021, in PubMed, the Web of Science, Embase, and Scopus, using a set ofkeywords related to our schemes, such as socioeconomics, lifestyle, infertility, and time to pregnancy. We shortlisted a combination ofavailable full texts, English publications, original research articles, human subjects, and nonpregnant women of childbearing age withthe intent of conceiving without medical assistance as the population of interest for further screening. Results:We included 43 Asian studies that reported modifiable socioeconomic and lifestyle risk factors with the following outcomes:time to pregnancy; pregnancy rate; or infertility rate. Similar to the Western populations, female infertility in Asian women was asso-ciated with advanced age at marriage, sexual dysfunction, elevated stress levels, and greater adiposity. Interestingly, a higher socioeco-nomic status in Asian women was positively associated with female infertility, whereas a higher socioeconomic status in their malepartners was inversely associated with couple infertility. Regrettably, few publications reported lifestyle risk factors, such as physicalactivity, dietary food groups, sleep disorders, and substance use. Conclusion:Asian women may have more infertility-related cultural and dietary diversity, and it is worthy of future research efforts. Itis also critical and more effective to tackle the infertility problem in both women and men. Hence, we discussed the imperative need forresearch efforts in Asian couples. (Fertil Steril Rev & Ograve;2023;4:78-99.& Oacute;2023 by American Society for Reproductive Medicine.)