Reply: International estimates on infertility prevalence and treatment seeking: potential need and demand for medical care

We welcome the in-depth attention Dyer gave our article on the international prevalence of infertility. Dyer questioned the validity of our conclusion on the basis of misinterpretation of original data, omission of relevant studies and extrapolation of data that was not representative across regions. In our study, we identified 25 population surveys evaluating infertility prevalence and reported the current median 12-month infertility prevalence to be 9% for more (3.5–16.7%) and less developed (9.2–9.3%) countries excluding studies using a 24 month period. Although this exclusion was made clear in the Results we did not re-iterate it in the Discussion or the Abstract and we agree with Dyer that this omission might have led to confusion about the pool of studies that were used to generate our median prevalence. It is of interest that where 12 and 24 month estimates were available from the same study, the difference was not large (8.5 and 7%, respectively) (Royal Commission, 1993). The prevalence of 9% for the less developed countries was also queried