Who receives a medical evaluation for infertility in the United States

Capsule:
In addition to financial access influencing who receives a medical evaluation for infertility, demographic and healthy lifestyle characteristics are associated with a medical evaluation for infertility among infertile women.

Authors:
Leslie V. Farland, Sc.M., Ai-ris Y. Collier, M.D., Katharine F. Correia, M.P.H., Francine Grodstein, Sc.D., Jorge E. Chavarro, M.D., Sc.D., Janet Rich-Edwards, Sc.D., Stacey A. Missmer, Sc.D.

Volume 105, Issue 5, Pages 1274-1280

Abstract:

Objective:
To investigate characteristics of receiving a medical evaluation for infertility among infertile women.

Design:
Prospective cohort.

Setting:
Academic institution.

Patient(s):
A total of 7,422 women who reported incident infertility between 1989 and 2009 in the Nurses’ Health Study II.

Intervention(s):
None.

Main Outcome Measure(s):
Report of receiving a medical evaluation for infertility.

Result(s):
Approximately 65% of women who reported infertility had a medical evaluation for infertility. Infertile women who were parous (relative risk [RR] = 0.81, 95% confidence interval [CI] 0.78–0.84), older, current smokers (RR = 0.89, 95% CI 0.83–0.96), or who had a higher body mass index (BMI) were less likely to report receiving a medical infertility evaluation. Infertile women who exercised frequently, took multivitamins (RR = 1.03, 95% CI 1.00–1.07), lived in states with comprehensive insurance coverage (RR = 1.09, 95% CI 1.00–1.19), had a high household income, or who had a recent physical examination (RR = 1.15, 95% CI 1.06–1.24) were more likely to report receiving a medical infertility evaluation.

Conclusion(s):
These findings highlight demographic, lifestyle, and access barriers to receiving medical infertility care. Historically, the discussion of barriers to infertility care has centered on financial access, geographic access, and socioeconomic status. Our findings build off literature by supporting previously reported associations and showcasing the importance of demographic and lifestyle factors in accessing care.

  • msamplaski

    These are interesting data. As a male fertility specialist, I would be interested to know similar information for our men. I would also be interested to know what proportion of men were seen independently vs as a partner to their subfertile female.

    • Leslie Farland

      Thank you for your comments. We agree that we also need to better understand the male barriers in accessing infertility care. Approximately 20% of women in our study report that their partner was diagnosed with male factor infertility. Unfortunately, we were not able to collect responses directly from men and because of the way the question was worded, we were not able to separate whether men sought care independently from their female partner. We hope that future research focuses on this subgroup specifically.

Translate »