Reproductive Health Surveillance Policy: Innovative Pre-marital Screening Model for Early Detection of Female Infertility Risks in Indonesia

Abstract

Female infertility in Indonesia remains a serious reproductive health challenge, with a prevalence of 10–15% among couples of reproductive ages. The low rate of early detection of ovulation and hormonal disorders means that many new cases are only identified after two years of marriage without pregnancy. A study by Kusuma et al. (2025) shows that 34.6% of married women experience infertility, while 36–40% of the population does not consider it a medical problem. The lack of fertility literacy and the absence of a surveillance system to monitor the risk of infertility exacerbate this condition. The proposed policy is the development of an Integrated Risk-Based Premarital Screening Model, which combines physical assessment, anthropometry, lifestyle assessment, and hormonal biomarker testing (AMH, LH, FSH), as well as evidencebased fertility counseling. This model is integrated into the national surveillance system through cross-sector collaboration between the Ministry of Health, the Ministry of Religious Affairs, and the National Population and Family Planning Agency (BKKBN). This policy directly contributes to the achievement of SDG 3 (Good Health and Well-being) and SDG 5 (Gender Equality) through a preventive, educational, and genderequitable approach to women's reproductive health in Indonesia.