Socioeconomic Factors and Fertility: The Impact of Poverty and Disadvantage on Reproductive Outcomes

Socioeconomic factors such as poverty and low education are linked to decreased fertility, highlighting disparities in reproductive health among disadvantaged populations.
Recent research highlights a significant link between socioeconomic disparities—such as poverty, lower educational attainment, and household income—and reduced fertility among women and men. A study published online on September 19, 2025, in JAMA Network Open, conducted by researchers including Dr. Aline J. Boxem from Erasmus MC University Medical Centre in Rotterdam, examined the association between social disadvantage and reproductive outcomes, focusing on subfertility and miscarriage risks.
The study involved a prospective cohort of 3,604 women and 2,557 male partners, tracking their fertility-related episodes from preconception onwards. It specifically measured the time to pregnancy, with subfertility defined as taking more than 12 months to conceive or the use of assisted reproductive technologies, and pregnancy loss before 22 weeks gestation.
Findings revealed that poverty and low educational levels are associated with lower fecundability, which refers to the probability of conceiving within a menstrual cycle. Specifically, women experiencing poverty had a fecundability ratio of 0.61, indicating a 39% reduction in the likelihood of conception compared to more advantaged groups. Similarly, low educational attainment among women and men was linked with decreased fecundability, with ratios of 0.61 and 0.72, respectively. Household income below €3,000 per month was also significantly associated with reduced fecundability, with a ratio of 0.59 compared to households earning €6,000 or more.
Interestingly, although social disadvantage impacts fertility, the study found no significant association between poverty or social markers and miscarriage risk. Demographic and lifestyle factors only partially explained the observed associations between social disadvantage and reduced fertility.
The researchers emphasize that recognizing social determinants alongside biological aspects of fertility can help develop targeted preventive strategies for couples wishing to conceive. Understanding the influence of socioeconomic factors on reproductive health is crucial for addressing disparities and improving fertility outcomes.
For more details, the original study can be accessed through JAMA Network Open.
source: https://medicalxpress.com/news/2025-09-poverty-social-disadvantage-linked-fecundability.html
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