Changes in sexual frequency among 51 150 infertile Chinese couples over the past 10 years
Authors: Zhu Yanwen , Wang Bian , Zhu Qianqian , Ye Jing , Kuang Yanping 
Published: February 2022

Abstract

STUDY QUESTION
How did the sexual frequency change and what are the related influencing factors among infertile Chinese couples over the past 10 years?

SUMMARY ANSWER
Sexual frequency has declined among infertile Chinese couples over the past decade, with such declines being most pronounced for women between the ages of 18 and 39.

WHAT IS KNOWN ALREADY
Many researchers have explored trends in coital frequency and variables associated among healthy individuals in other nations. There have been major changes in all aspects of Chinese life and society over the past decade, including two major fertility policy adjustments. The sexual habits of infertile couples in China remain poorly understood and warrant further investigation.

STUDY DESIGN, SIZE, DURATION
A retrospective cohort study of 51 150 infertile couples that visited our facility between January 2011 and December 2020 at a tertiary care academic medical centre.

PARTICIPANTS/MATERIALS, SETTING, METHODS
The primary outcome for this study was whether couples had engaged in sexual intercourse ≤4 times/month or &gt;4 times/month. Multivariable logistic regression analyses were performed to detect the association between the variables and sexual frequency. Analyses were further performed to determine whether observed trends remained evident in women from different age subgroups. To assess whether these trends differed before and after the introduction of the universal two-child policy in China (January 2016), we additionally assessed trends in these age subgroups of women relative to the time at which this policy was introduced.

MAIN RESULTS AND THE ROLE OF CHANCE
The proportion of couples reporting having engaged in sexual intercourse &gt;4 times/month fell over the past decade from 62.7% (2011–2013) to 55.9% (2014–2015) to 52.7% (2016–2020). Declines in sexual frequency were evident for women between the ages of 18 and 39 (P &lt; 0.05), whereas no such changes were evident for women between the ages of 40 and 50. Younger men and women, as well as individuals with a less than junior college education level, reported higher frequencies of sexual intercourse. For women, being remarried and having a more recent diagnosis of infertility were associated with increased coital frequency. This frequency decreased progressively for women as BMI values increased. There was no detected relationship between coital frequency and nationality or history of prior births.

LIMITATIONS, REASONS FOR CAUTION
These analyses were dependent on self-reported data, and may thus have been impacted by the over- or under-reporting of sexual frequency as a consequence of social desirability bias. In addition, not all potentially relevant variables were assessed in all analyses, and certain potentially relevant variables such as family income or pornography use were not measured in any analyses.

WIDER IMPLICATIONS OF THE FINDINGS
Sexual frequency is closely related to infertility risks. This general downward trend in sexual frequency may warrant concern. At present, these reductions remain an interesting yet unexplained topic worthy of further study.

STUDY FUNDING/COMPETING INTEREST(S)
This study was funded by the National Key Research and Development Program of China (Grant no. 2018YFC1003000) and the National Natural Science Foundation of China (Grant no. 81771533). The authors declare no conflict of interest.

TRIAL REGISTRATION NUMBER
N/A.