Self-reported fertility problems and their socio-demographic and health correlates: a cross-sectional online survey of 8000 Polish adults.

Among adults who had attempted to conceive, 28.9% of the analytical sample reported fertility problems, with a notable sex difference.

• The analytical sample comprised 5,532 respondents out of 8,000 total surveyed.
• 36.6% of women reported fertility problems compared to 17.4% of men.
• The sample included 3,316 women and 2,216 men.
• The survey was conducted in 2024 as the 'National Fertility Test' in Poland.

Fallopian tube obstruction showed the strongest association with self-reported fertility problems among women.

• Fallopian tube obstruction had an odds ratio of 23.0.
• This was the highest OR observed among all variables examined in women.
• Analysis used sex-specific, age-adjusted, Holm-Bonferroni-corrected logistic regression.
• This finding confirms an established clinical correlate of female infertility.

Polycystic ovary syndrome (PCOS) and endometriosis were significantly associated with fertility problems in women.

• PCOS was associated with an odds ratio of 5.35.
• Endometriosis was associated with an odds ratio of 2.82.
• Both conditions are established clinical risk factors for female infertility.
• Thyroid disease was also identified among the strongest factors for women according to the lay summary.

A history of prior pregnancy and better self-rated mental health were associated with lower odds of reporting fertility problems among women.

• Prior pregnancy history was associated with an OR of 0.26, indicating substantially lower odds of reporting fertility problems.
• Better self-reported mental health was associated with an OR of 0.76.
• Both variables remained significant after Holm-Bonferroni correction for multiple comparisons.

Among men, varicocele or epididymal cysts and a history of sexually transmitted infection were significantly associated with fertility problems.

• Varicocele or epididymal cysts were associated with an OR of 3.08.
• History of sexually transmitted infection (STI) was associated with an OR of 4.60.
• Use of reproductive supplements was also associated with an OR of 4.06 in men, though this likely reflects reverse causation and help-seeking behavior rather than a causal risk factor.

Associations with supplement use and specific conception strategies likely reflect reverse causation rather than causal risk factors in both sexes.

• Reproductive supplement use had an OR of 4.06 in men.
• The authors interpret these associations as 'marking active help-seeking rather than causal risk factors.'
• Specific conception strategies showed similar patterns of likely reverse causation in both sexes.
• The authors explicitly caution against causal interpretation of these behavioral variables.

The self-selected online sampling method limits generalizability, and findings should not be interpreted as population-level prevalence estimates for Poland.

• The survey was conducted online, introducing self-selection bias.
• Results 'likely reflect participation bias from people currently attempting to conceive' according to the lay summary.
• The authors state these findings 'should not be interpreted as population-level prevalence estimates for Poland.'
• Despite this limitation, the study confirms 'established clinical correlates alongside distinct socio-demographic and lifestyle patterns.'

The study identified a strong need for targeted reproductive health education in Poland.

• The authors conclude findings underscore 'the need for targeted reproductive health education.'
• The lay summary describes 'a strong, critical need for better health education and support tailored specifically to the Polish public.'
• Comprehensive data integrating socio-demographic, lifestyle, and health correlates within a contemporary Polish context were previously limited.
• The study covered socio-demographic, lifestyle, and health variables simultaneously.