Rural vs. Urban Fertility: A Surreal Image

Fertility Factors: Where You Live and IVF Success

Samir D’Costa in Health & Wellness December 2025 • 4 min read.

"Does your environment affect your chances of conceiving? A look at how rural vs. urban living impacts IVF outcomes."

The journey to parenthood through in vitro fertilization (IVF) is often complex, influenced by many factors. Maternal age and hormone levels are critical, and lifestyle choices also play a role. But what about where you live? Does your environment affect your fertility?

Studies have explored how physical, social, and economic factors impact fertility. Obesity and smoking are well-known culprits, and exposure to certain chemicals can also affect reproductive health. However, there's less research on how different environments, such as rural vs. urban settings, might influence IVF success.

This article delves into a study comparing IVF outcomes among women in rural areas, small towns, and large cities. We'll explore whether ovarian reserve parameters, like Anti-Müllerian hormone (AMH) levels, differ across these groups and how these factors relate to the overall success of IVF.

Rural vs. Urban: What the Research Says About IVF

Rural vs. Urban Fertility: A Surreal Image

A recent study analyzed data from 1,265 women undergoing IVF at the Invicta Fertility Center between May 2011 and July 2012. The research focused on women undergoing their first IVF cycle with intracytoplasmic sperm injection (ICSI), a common IVF technique, and who followed a long stimulation protocol. All participants also had their AMH levels measured using the same DSL kit to ensure consistent results. After applying specific inclusion and exclusion criteria, the study ultimately included 651 women, categorized by their place of residence: rural areas, small towns (under 100,000 inhabitants), and large cities (over 100,000 inhabitants).

The study aimed to determine if there were notable differences in IVF outcomes based on where women lived. The researchers examined several factors, including:

Age
Body Mass Index (BMI)
AMH and inhibin B levels
Gonadotropin dosage
Antral follicle count (AFC)
Fertilization rate
Clinical pregnancy rate
Miscarriage rate

Interestingly, the study found that women in large cities were, on average, older than those in rural areas or small towns. This could be due to various social and economic factors that lead women in urban settings to delay starting families. The results also showed that women from rural areas had a significantly higher BMI compared to those in small and large towns. However, despite these differences, key ovarian reserve parameters like AMH and inhibin B levels, as well as the number of gonadotropin ampules needed for stimulation and antral follicle count, did not significantly vary among the groups. There was no significant group difference in clinical pregnancy rates, either per started cycle or per embryo transfer.

The Takeaway: Environment May Not Be a Deciding Factor

The study suggests that inhabiting rural areas, small towns and large cities, may not have a big impact on IVF success. However, it's crucial to remember that this is just one study, and further research is needed to confirm these findings and explore other potential environmental factors that may play a role in fertility. Lifestyle choices, access to healthcare, and individual health conditions likely have a more significant influence.

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This article is based on research published under:

DOI-LINK: 10.26444/aaem/78944, Alternate LINK

Title: Demographic Characteristics And Amh Levels In Rural And Urban Women Participating In An Ivf Programme

Subject: Public Health, Environmental and Occupational Health

Journal: Annals of Agricultural and Environmental Medicine

Publisher: Institute of Rural Health

Authors: Michał Kunicki, Krzysztof Łukaszuk, Joanna Liss, Grzegorz Jakiel, Patrycja Skowrońska

Published: 2018-03-14

Everything You Need To Know

Does where I live really impact my chances of IVF success?

According to a study comparing IVF outcomes, the location of residence, whether in rural areas, small towns, or large cities, may not significantly impact the success of in vitro fertilization. The research indicates that key ovarian reserve parameters, like Anti-Müllerian hormone (AMH) and inhibin B levels, along with factors like gonadotropin dosage and antral follicle count, did not show significant differences across the different residential groups. Clinical pregnancy rates also did not vary considerably. However, individual health conditions, lifestyle choices, and access to healthcare likely have a more significant impact on IVF outcomes, and further research is needed to confirm these findings and explore additional environmental factors.

What factors did the study use to compare IVF outcomes across different living environments?

The study assessed several factors to compare IVF outcomes in rural areas, small towns, and large cities. These included the age of the participants, their Body Mass Index (BMI), and ovarian reserve parameters such as Anti-Müllerian hormone (AMH) and inhibin B levels. They also examined gonadotropin dosage, antral follicle count (AFC), fertilization rates, clinical pregnancy rates, and miscarriage rates. The study measured AMH levels using the same DSL kit to ensure consistent results across the different residential categories.

What are the key ovarian reserve parameters that the study examined?

The study examined several key ovarian reserve parameters to assess their relationship with IVF success across different living environments. The key parameters included Anti-Müllerian hormone (AMH) levels, which is a marker of ovarian reserve. Also, inhibin B levels were evaluated. Additionally, the research looked at the antral follicle count (AFC), which is the number of small follicles visible in the ovaries during an ultrasound. These factors were compared among women living in rural areas, small towns, and large cities to determine if there were any significant variations that might impact IVF outcomes.

Did the study find any differences in the age or BMI of women in different residential areas?

Yes, the study revealed differences in both age and Body Mass Index (BMI) among women from different residential areas. Women in large cities were, on average, older than those in rural areas or small towns, potentially due to social and economic factors. Additionally, women from rural areas had a significantly higher BMI compared to those in small and large towns. However, the study noted that despite these variations, these differences did not significantly influence the key ovarian reserve parameters or the overall success rates of IVF.

Can you explain how the study was conducted, including the methods used?

The study analyzed data from 1,265 women undergoing IVF at the Invicta Fertility Center. The study focused on women undergoing their first IVF cycle with intracytoplasmic sperm injection (ICSI), a common IVF technique, and who followed a long stimulation protocol. All participants also had their Anti-Müllerian hormone (AMH) levels measured using the same DSL kit to ensure consistent results. After applying specific inclusion and exclusion criteria, the study included 651 women, categorized by their place of residence: rural areas, small towns (under 100,000 inhabitants), and large cities (over 100,000 inhabitants). The study then compared various factors like age, BMI, AMH levels, gonadotropin dosage, antral follicle count, fertilization rate, clinical pregnancy rate, and miscarriage rate across these groups to determine any significant differences related to IVF outcomes.