Abstract

Background: Intimate partner violence (IPV) and infertility are significant global health concerns on women’s health and rights. In a patriarchal society, a woman’s value is unfairly defined by the motherhood. Evidence has shown that infertile women face a higher risk of IPV, yet high-quality data on its prevalence among this population remains limited. This study aims to quantify the prevalence of IPV against infertile women in China and identify associated risk factors.

Methods: A national cross-sectional study was conducted in China from October 2021 to August 2022, using multistage stratified cluster sampling. Infertile women were recruited from 30 reproductive centres across ten provinces. A self-administered questionnaire, including the Revised Conflict Tactics Scale (CTS-2) and the Scale of Economic Abuse-12 (SEA-12), measured IPV in the past 12 months and over a lifetime. A structural equation model (SEM) explored risk factors for past-12-month IPV victimization.

Findings: A total of 12,392 infertile women were included. The weighted 12-month prevalence of IPV against infertile women was 34.1% (95% CI: 33.2–34.9), and lifetime prevalence was 44.2% (95% CI: 43.3–45.1). The SEM analysis identified female-factor infertility (standardized coefficient: standardized coefficient: 0.0473, p=0.0118) and ever-experienced infertility treatment failure (0.0774, p<0.0001) as direct drivers of 12-month IPV victimization. Other factors included the participant’s unstable employment (0.0442, p=0.0059), non-nuclear family structure (0.0479, p=0.0130), and the current male partner’s adverse behaviours (0.5470, p<0.0001).

Interpretation: Globally, this is the first national-level study to examine IPV against infertile women, revealing a high prevalence rate in China. The findings underscored the need for gender-transformative interventions and improved access to infertility care to reduce the dual burden of IPV and infertility.