Who receives a medical evaluation for infertility
in the United States?
Infertility is prevalent in the United States (1.5 million couples per year). Nonetheless, it has been reported that only 41-46% of women dealing with infertility use infertility services (according to the National Survey for Family Growth). The results of a clinical study on the medical evaluation tendencies in women are summarized below.
In a clinical study, 7422 women who reported infertility (between 1989 to 2009) were analyzed. The reports of previous studies were used, such as the Nurse’s Health Study II (NHS II).
The results show that only 65% of patients reported a previous medical infertility evaluation. The mean age at the first report of infertility was 35.1 years among those who reported medical evaluation for infertility and 36.2 years among those who did not.
Access to the services seems to play an essential role in the medical evaluation for infertility, and different factors have been shown to influence it - such as race, marriage, male partner's education and lifestyle factors (smoking status, alcohol intake, multivitamin use, and physical activity).
Not surprisingly, a good financial status, insurance coverage, and connection with the medical system were all predictors of a previous medical evaluation for infertility in this cohort.
When evaluating the association between lifestyle factors and fertility evaluation, a consistent pattern emerged. Infertile women who reported behaviors that are generally regarded as “healthy lifestyle” were more likely to report having had an evaluation than their peers who exhibited less “healthy lifestyle” behaviors.
The findings of this work may help guide clinicians who serve as first-line providers for many women who are suffering from uninvestigated infertility. Infertility diagnosis and treatment is now a public health priority for the Centers for Disease Control and Prevention.
More details of the study are shown below. For the original publication, click here.
The possible infertility causes for female patients were also reported:
1) 9% reported tubal infertility
2) 27% reported ovulatory dysfunction
3) 12% reported other reasons, and;
4) 33% reported that the reason for infertility was not found.
Men also played an interesting role in the evaluation: Infertile women whose male partners had graduate-level education were more likely to report an evaluation than women whose partners had attained less than a 4-year college degree.
The study also showed that infertile women who had children were less likely to report a medical evaluation compared with infertile women who had no children.
In addition, those with a history of surgically confirmed endometriosis were more likely to report having a medical evaluation, and a history of spontaneous abortion was not associated with evaluation.
Infertile women who were current smokers were less likely to report having a medical evaluation than never smokers.
Women who used vitamins were more likely to report evaluation.
Not surprisingly, infertile women who resided in states with any level of state-mandated insurance coverage for infertility treatment were more likely to report having an infertility evaluation compared with those residing in states without it. Also, women who had a recent general physical examination or an examination for symptoms of any health condition were more likely to report having a fertility evaluation.