Generational changes in self-reported infertility among migrants in Australia.

Knowledge about the perinatal and reproductive health of international migrants remains limited due to their marginalization in health and social-epidemiological research. We address this gap by analysing the prevalence of self-reported infertility among three migrant generations, migrants from different regions of origin, and comparing it to the majority of third-generation plus in Australia. We examine whether infertility risk differs across these groups and to what extent socio-demographic characteristics account for observed differences. The analysis draws on pooled data from the 2011, 2015, and 2019 waves of the Household, Income, and Labour Dynamics in Australia (HILDA) survey, the waves in which self-reported infertility was assessed. Average prevalence of current infertility is 11.8% among women and 7.5% among men. Multivariable findings from this study align with the healthy migrant hypothesis, which suggests that migrants tend to have a health advantage over the majority population at destination which is driven by selection into migration. Australia's immigration policy contributes to such selection effects as it favours immigration of skilled and healthy individuals, who likely have a lower risk of infertility. The health advantage of the migrant generations 1 and 1.5 occurs for all origin groups except for migrants from English-speaking countries. This advantage diminishes for the second generation. In light of the high levels of self-reported infertility in this study, results suggest that Australia's reproductive health policies need to address the specific needs of Australia's increasingly diverse population.