Global, Regional, and National Burden of Infertility Related to Polycystic Ovary Syndrome Among Adolescents and Young Adults from 1990 to 2021: A Systematic Analysis Based on the Global Burden of Disease Study

Background Polycystic ovary syndrome (PCOS) is a common endocrine disorder and a leading cause of anovulatory infertility among women. This study aimed to systematically analyze the global, regional, and national burden of PCOS-related infertility among adolescents and young adults from 1990 to 2021 using data from the Global Burden of Disease (GBD) study. Methods Data on PCOS-related primary and secondary infertility were extracted from the GBD database for individuals aged 15–24 years across 204 countries and territories, 21 GBD regions, and five Socio-Demographic Index (SDI) regions from 1990 to 2021. Disease burden indicators, including age-standardized prevalence rate (ASPR), age-standardized years lived with disability (YLD) rate, crude prevalence rate (CPR), and crude YLD rate, were analyzed using descriptive statistics, joinpoint regression analysis, health inequality analysis, and the Bayesian age-period-cohort (BAPC) model. Results From 1990 to 2021, the global number of prevalent cases of PCOS-related infertility increased from 1,754,952 (95% uncertainty interval [UI]: 1,137,659–2,608,426) to 3,024,023 (95% UI: 1,954,547–4,462,463), with the ASPR rising from 173.86/100,000 to 247.64/100,000 (average annual percentage change [AAPC] = 1.16, 95% confidence interval [CI%]: 1.10–1.23). The global YLDs due to PCOS-related infertility rose from 11,039 (95% UI: 4,321–25,141) to 18,662 (95% UI: 7,193–42,767), and the age-standardized YLD rate increased to 1.53/100,000 (AAPC = 1.10, 95% CI%: 1.03–1.18). The burden of PCOS-related infertility varied significantly across regions and countries. In 2021, the highest ASPR (565.44/100,000) and the highest age-standardized YLD rate (3.89/100,000) were observed in Italy. The BAPC model predicted that the global ASPR and age-standardized YLD rate of PCOS-related infertility would continue to rise from 2022 to 2050. Conclusion The burden of PCOS-related infertility among adolescents and young adults has been increasing globally, with significant disparities across regions and countries. This study highlights the need for targeted interventions and improved access to healthcare services to address the rising burden of PCOS-related infertility, particularly in low- and middle-income countries.