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 Researchers examined survey data collected between 2013 and 2016
from 2,052 women, ages 20 to 44, who were representative of more
than 45 million women nationwide.
Overall, 12.5% of the women reported trying to conceive for one year
without becoming pregnant, the timeline doctors typically use to
define infertility. Just a third of those making less than $25,000 a
year sought treatment for infertility, compared with two thirds of
those making $100,000 or more, researchers report in Fertility and
Sterility.
"People of all races, education levels, incomes, citizenship
statuses, health insurances and sites of health care use report
similar rates of having infertility," said Dr. James Dupree, an
assistant professor of urology and obstetrics and gynecology at the
University of Michigan in Ann Arbor.
"Women with less education, lower incomes, non-citizens and women
without health insurance and without access to physician offices did
not see their doctors as often for help with infertility," Dupree
said by email. "So, patients and families should know that if they
have infertility, they're not alone, and they should go to see their
doctor for help."
Most healthy couples can conceive within three to six months,
although the process can take longer for people who are older or who
have fertility compromised by certain medical conditions or
lifestyle habits.
Infertility rates in the study ranged from 5.8% among women 20 to 24
years old up to 20.5% among women 40 to 44 years old.
Older women were also more likely to seek help: 67.3% of women 35 to
39 years old with infertility saw a medical provider, as did 61.7%
of infertile women 40 to 44 years old. Only 11.7% of women 20 to 24
years old sought treatment for infertility.
Among women earning under $25,000 a year, 33.1% of women with
infertility sought treatment, compared with 66.8% of infertile women
earning at least $100,000 annually.
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Only 33.1% of women without education beyond high school saw a
medical provider for infertility, compared with 80.8% of women with
college degrees.
And 65.3% of white women and 79.8% of Asian women with infertility
sought treatment, compared with 40.6% of black women, 44% of Mexican
American women and 54.9% of women of other Hispanic backgrounds.
While 65% of women with insurance saw medical providers for
infertility treatment, only 39.7% of women without health insurance
did.
The study doesn't prove whether or how specific patient
characteristics influence a woman's choice to seek help for
infertility.
Even so, the results offer fresh evidence of disparities in access
to care, said Dr. Kevin Doody, director of CARE Fertility in Fort
Worth, Texas, and past president of the Society for Assisted
Reproductive Technology.
"Access to infertility care has several barriers including patient
lack of awareness, geographic access to specialists, financial
burdens and time burdens," Doody, who wasn't involved in the study,
said by email.
Even with insurance, many women may lack benefits for infertility
care or face other obstacles to treatment, said Dr. Emily Jungheim,
chief of reproductive endocrinology and infertility at Washington
University in St. Louis.
"Perhaps women with more education and more income are in positions
where they can take the time off for treatment," Jungheim, who
wasn't involved in the study, said by email.
"Maybe they have better benefits overall and can take medical
leave," Jungheim added. "Or they have a boss who is flexible with
their plans – or they are the boss and can make their own schedule."
SOURCE: https://bit.ly/2Y2Y5Rq Fertility and Sterility, online June
28, 2019.
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