Race and Length of Time Pursuing Pregnancy Among Women Who Utilized Medical Help to Get Pregnant
Abstract
Objective: The evaluation of racial disparities in access to and use of infertility services in the U.S. has been documented. The aims of this study were to: 1) investigate racial differences in length of time women report attempting to become pregnant until seeking medical help; and 2) determine the predictors of seeking medical help to achieve pregnancy.
Materials and methods: The National Survey of Family Growth 2011-2015 was used to analyze the duration women attempted to get pregnant among those who sought medical help.
Results: 563 women reported seeking medical help to achieve pregnancy. The majority 422 (81%) were white. Multiple linear regression showed that age (β = .93; p = .00), having less than high school education (β = 14.64; p = .01), and higher body mass index (β = .59; p = .00) are significantly associated with an increased length of time for seeking medical help to get pregnant. Religions other than Catholic or Protestant (β = -8.63; p = .04) is significantly associated with a decreased length of time for seeking medical help to get pregnant. Race was not associated with a significant difference in the length of time attempting to become pregnant (β = -1.80; p = .44).
Conclusion: Age, education attainment, religious affiliation, and body mass index are significantly associated with the length of time pursuing pregnancy. Once women have utilized medical resources, racial differences in the length of time pursuing pregnancy are not apparent.
1. Habbema JD, Collins J, Leridon H, Evers JL, Lunenfeld B, te Velde ER. Towards less confusing terminology in reproductive medicine: a proposal. Hum Reprod 2004; 19: 1497-501.
2. Thoma ME, McLain AC, Louis JF, King RB, Trumble AC, Sundaram R, et al. Prevalence of infertility in the United States as estimated by the current duration approach and a traditional constructed approach. Fertil Steril 2013; 99: 1324-31.
3. Mascarenhas MN, Cheung H, Mathers CD, Stevens GA. Meas¬uring infertility in populations: constructing a standard definition for use with demographic and reproductive health surveys. Popul Health Metr 2012; 10: 17.
4. Larsen U. Research on infertility: which definition should we use? Fertil Steril 2005; 83: 846-52.
5. Baird DD, Wilcox AJ, Weinberg CR. Use of time to pregnancy to study environmental exposures. Am J Epidemiol 1986; 124: 470-80.
6. Joffe M, Villard L, Li Z, et al. Long-term recall of time-to-pregnancy. Fertil Steril 1993; 60: 99-104.
7. Tuntiseranee P, Olsen J, Chongsuvivatwong V, Limbutara S. Fecundity in Thai and European regions: results based on waiting time to pregnancy. Hum Reprod 1998; 13: 471-7.
8. Bitler M, Schmidt L. Health disparities and infertility: Impacts of state-level insurance mandates. Fertil Steril 2006; 85: 858-65.
9. Chin HB, Howards PP, Kramer MR, Mertens AC, Spencer JB. Racial disparities in seeking care for help getting pregnant. Paediatr Perinat Epidemiol 2015; 29: 416-25.
10. Chandra A, Copen CE, Stephen EH. Infertility and impaired fecundity in the United States, 1982-2010: data from the National Survey of Family Growth. Natl Health Stat Report 2013; (67): 1-18.
11. Dimitriadis I, Batsis M, Petrozza JC, Souter I. Racial disparities in fertility care: an analysis of 4537 intrauterine insemination cycles. Journal of Racial and Ethnic Health Disparities 2017; 4: 169-77.
12. Seifer DB, Frazier LM, Grainger DA. Disparities in assisted reproductive technologies outcomes in Black women compared with White women. Fertil Steril 2008; 90: 1701-10.
13. Missmer SA, Seifer DB, Jain T. Cultural factors contributing to health care disparities among patients with infertility in Midwestern United States. Fertil Steril 2011; 95:1943-9.
14. Huddleston HG, Cedars MI, Sohn SH, Giudice LC, Fujimoto VY. Racial and ethnic disparities in reproductive endocrinology and infertility. Am J Obstet Gynecol 2010; 202: 413-9.
15. Jain T. Socioeconomic and racial disparities among infertility patients seeking care. Fertil Steril 2006; 85: 876-81.
16. Lamb JD, Purcell KJ, Modan AE, Vittinghoff E, Huddleston HG,Fujimoto VY. Asian ethnicity is associated with longer duration of infertility and decreased pregnancy rates following intrauterine insemination. Fertil Steril 2007; 88: S260-1.
17. Lamb JD, Huddleston HG, Purcell KJ, Modan A, Farsani TT, Dingeldein MA, et al. Asian ethnicity is associated with decreased pregnancy rates following intrauterine insemination. Reprod BioMed Online 2009; 19: 252-6.
18. Janitz AE, Peck JD, Craig LB. Racial/Ethnic differences in the utilization of infertility services: a focus on American-Indian/Alaska-Natives. Matern Child Health J 2019; 23:10-8.
19. Jain T, Hornstein MD. Disparities in access to infertility services in a state with mandated insurance coverage. Fertil Steril 2005; 84: 221-3.
20. Chandra A, Copen CE, Stephen EH. Infertility service use in the United States: data from the National Survey of Family Growth, 1982-2010. Natl Health Stat Report 2014; (73): 1-21.
21. Schmidt L, Munster K, Helm P. Infertility and the seeking of infertility treatment in a representative study population. British Journal of Obstetrics and Gynaecology 1995; 102: 978-84.
22. Greil AL, McQuillan J, Shreffler KM, Johnson KM, Slauson-Blevins KS. Race-ethnicity and medical services for infertility: stratified reproduction in a population-based sample of U.S. women. J Health Soc Behav 2011; 52: 493-509.
23. About the National Survey of Family Growth. National Center for Health Statistics.
https://www.cdc.gov/nchs/nsfg/about_nsfg.htm (access October 23rd, 2018).
24. Kessler LM, Craig BM, Plosker SM, Reed DR, Quinn GP. Infertility evaluation and treatment among women in the United States. Fertil Steril 2013; 100: 1025-32.
25. Wise LA, Rothman KJ, Mikkelsen EM, Sorensen HT, Riis A, Hatch EE. An internet-based prospective study of body size and time-to pregnancy. Hum Reprod 2010; 25: 253-64.
26. Talmor A, Dunphy B. Female obesity and infertility. Best Pract Res Clin Obstet Gynaecol 2015; 29:
498-506.
27. Gesink Law DC, Maclehose RF, Longnecker MP. Obesity and time to pregnancy. Hum Reprod 2007; 22: 414-20.
28. Silvestris E, de Pergola G, Rosania R, Loverro G. Obesity as disruptor of the female fertility. Reprod Biol Endocrinol 2018; 16: 22.
29. Kazemijaliseh H, Ramezani Tehrani F, Behboudi-Gandevani S, Hosseinpanah F, Khalili D, Azizi F. The Prevalence and Causes of Primary Infertility in Iran: A Population-Based Study. Glob J Health Sci 2015; 7: 226-32.
30. Rich-Edwards JW, Spiegelman D, Garland M,
Hertzmark E, Hunter DJ, Colditz GA, et al. Physical activity, body mass index, and ovulatory disorder infertility. Epidemiology 2002; 13: 184-90.
31. Sneed ML, Uhler ML, Grotjan HE, Rapisarda JJ, Lederer KJ, Beltsos AN. Body mass index: impact on IVF success appears age related. Hum Reprod 2008; 23: 1835-39.
32. Chandra A, Stephen EH. Infertility service use among U.S. women: 1995 and 2002. Fertil Steril 2010; 93: 725-36.
33. Greil AL, McQuillan J. Help-seeking patterns among subfecund women. Journal of Reproductive and Infant Psychology 2004; 22: 305-19.
34. Mosalanejad L, Parandavar N, Abdollahifard S. Barriers to infertility treatment: an integrated study. Glob J Health Sci 2013; 6: 181-91.
35. Viau PA, Padula CA, Eddy B. An exploration of health concerns & health-promotion behaviors in pregnant women over age 35. MCN American Journal of Maternal Child Nursing 2002; 27: 328-34.
36. Bunting L, Tsibulsky I, Boivin J. Fertility knowledge and beliefs about fertility treatment: findings from the International Fertility Decision-making Study. Hum Reprod 2013; 28: 385-97.
37. Jansen NA, Saint Onge JM. An internet forum analysis of stigma power perceptions among women seeking fertility treatment in the United States. Soc Sci Med 2015; 147: 184-9.
38. Bunting L, Boivin J. Decision-making about seeking medical advice in an internet sample of women trying to get pregnant. Hum Reprod 2007; 22: 1662-8.
39. Akhondi MM, Ranjbar F, Shirzad M, Behjati Ardakani
Z, Kamali K, Mohammad K. Practical difficulties in estimating the prevalence of primary infertility in Iran. Int J Fertil Steril 2019; 13: 113-7.
40. Dick ML, Bain CJ, Purdie DM, Siskind V, Molloy D, Green AC. Self-reported difficulty in conceiving as a measure of infertility. Hum Reprod 2003; 18: 2711-7.
41. Asser SM, Swan R. Child fatalities from religion-motivated medical neglect. Pediatrics 1998; 101: 625-9.
42. Muramoto O. Recent developments in medical care of Jehovah’s Witnesses. West J Med 1999; 170: 297-301.
43. Sallam HN, Sallam NH. Religious aspects of assisted reproduction. Facts Views Vis Obgyn 2016; 8: 33-48.
44. Datta J, Palmer MJ, Tanton C, Gibson LJ, Jones KG, Macdowall W, et al. Prevalence of infertility and help seeking among 15000 women and men. Hum Reprod 2016; 31: 2108-18.
45. Fujimoto VY, Luke B, Brown MB, Jain T, Armstrong A, Grainger DA, et al. Racial and ethnic disparities in assisted reproductive technology outcomes in the United States. Fertil Steril 2010; 93: 382-90.
46. Shuler A, Rodgers AK, Budrys NM, Holden A, Schenken RS, Brzyski RG. In vitro fertilization outcomes in Hispanics versus non-Hispanic Whites. Fertil Steril 2011; 95: 2735-7.
47. Weinberg CR, Baird DD, Wilcox AJ. Sources of bias in studies of time to pregnancy. Stat Med 1994; 13: 671-81.
2. Thoma ME, McLain AC, Louis JF, King RB, Trumble AC, Sundaram R, et al. Prevalence of infertility in the United States as estimated by the current duration approach and a traditional constructed approach. Fertil Steril 2013; 99: 1324-31.
3. Mascarenhas MN, Cheung H, Mathers CD, Stevens GA. Meas¬uring infertility in populations: constructing a standard definition for use with demographic and reproductive health surveys. Popul Health Metr 2012; 10: 17.
4. Larsen U. Research on infertility: which definition should we use? Fertil Steril 2005; 83: 846-52.
5. Baird DD, Wilcox AJ, Weinberg CR. Use of time to pregnancy to study environmental exposures. Am J Epidemiol 1986; 124: 470-80.
6. Joffe M, Villard L, Li Z, et al. Long-term recall of time-to-pregnancy. Fertil Steril 1993; 60: 99-104.
7. Tuntiseranee P, Olsen J, Chongsuvivatwong V, Limbutara S. Fecundity in Thai and European regions: results based on waiting time to pregnancy. Hum Reprod 1998; 13: 471-7.
8. Bitler M, Schmidt L. Health disparities and infertility: Impacts of state-level insurance mandates. Fertil Steril 2006; 85: 858-65.
9. Chin HB, Howards PP, Kramer MR, Mertens AC, Spencer JB. Racial disparities in seeking care for help getting pregnant. Paediatr Perinat Epidemiol 2015; 29: 416-25.
10. Chandra A, Copen CE, Stephen EH. Infertility and impaired fecundity in the United States, 1982-2010: data from the National Survey of Family Growth. Natl Health Stat Report 2013; (67): 1-18.
11. Dimitriadis I, Batsis M, Petrozza JC, Souter I. Racial disparities in fertility care: an analysis of 4537 intrauterine insemination cycles. Journal of Racial and Ethnic Health Disparities 2017; 4: 169-77.
12. Seifer DB, Frazier LM, Grainger DA. Disparities in assisted reproductive technologies outcomes in Black women compared with White women. Fertil Steril 2008; 90: 1701-10.
13. Missmer SA, Seifer DB, Jain T. Cultural factors contributing to health care disparities among patients with infertility in Midwestern United States. Fertil Steril 2011; 95:1943-9.
14. Huddleston HG, Cedars MI, Sohn SH, Giudice LC, Fujimoto VY. Racial and ethnic disparities in reproductive endocrinology and infertility. Am J Obstet Gynecol 2010; 202: 413-9.
15. Jain T. Socioeconomic and racial disparities among infertility patients seeking care. Fertil Steril 2006; 85: 876-81.
16. Lamb JD, Purcell KJ, Modan AE, Vittinghoff E, Huddleston HG,Fujimoto VY. Asian ethnicity is associated with longer duration of infertility and decreased pregnancy rates following intrauterine insemination. Fertil Steril 2007; 88: S260-1.
17. Lamb JD, Huddleston HG, Purcell KJ, Modan A, Farsani TT, Dingeldein MA, et al. Asian ethnicity is associated with decreased pregnancy rates following intrauterine insemination. Reprod BioMed Online 2009; 19: 252-6.
18. Janitz AE, Peck JD, Craig LB. Racial/Ethnic differences in the utilization of infertility services: a focus on American-Indian/Alaska-Natives. Matern Child Health J 2019; 23:10-8.
19. Jain T, Hornstein MD. Disparities in access to infertility services in a state with mandated insurance coverage. Fertil Steril 2005; 84: 221-3.
20. Chandra A, Copen CE, Stephen EH. Infertility service use in the United States: data from the National Survey of Family Growth, 1982-2010. Natl Health Stat Report 2014; (73): 1-21.
21. Schmidt L, Munster K, Helm P. Infertility and the seeking of infertility treatment in a representative study population. British Journal of Obstetrics and Gynaecology 1995; 102: 978-84.
22. Greil AL, McQuillan J, Shreffler KM, Johnson KM, Slauson-Blevins KS. Race-ethnicity and medical services for infertility: stratified reproduction in a population-based sample of U.S. women. J Health Soc Behav 2011; 52: 493-509.
23. About the National Survey of Family Growth. National Center for Health Statistics.
https://www.cdc.gov/nchs/nsfg/about_nsfg.htm (access October 23rd, 2018).
24. Kessler LM, Craig BM, Plosker SM, Reed DR, Quinn GP. Infertility evaluation and treatment among women in the United States. Fertil Steril 2013; 100: 1025-32.
25. Wise LA, Rothman KJ, Mikkelsen EM, Sorensen HT, Riis A, Hatch EE. An internet-based prospective study of body size and time-to pregnancy. Hum Reprod 2010; 25: 253-64.
26. Talmor A, Dunphy B. Female obesity and infertility. Best Pract Res Clin Obstet Gynaecol 2015; 29:
498-506.
27. Gesink Law DC, Maclehose RF, Longnecker MP. Obesity and time to pregnancy. Hum Reprod 2007; 22: 414-20.
28. Silvestris E, de Pergola G, Rosania R, Loverro G. Obesity as disruptor of the female fertility. Reprod Biol Endocrinol 2018; 16: 22.
29. Kazemijaliseh H, Ramezani Tehrani F, Behboudi-Gandevani S, Hosseinpanah F, Khalili D, Azizi F. The Prevalence and Causes of Primary Infertility in Iran: A Population-Based Study. Glob J Health Sci 2015; 7: 226-32.
30. Rich-Edwards JW, Spiegelman D, Garland M,
Hertzmark E, Hunter DJ, Colditz GA, et al. Physical activity, body mass index, and ovulatory disorder infertility. Epidemiology 2002; 13: 184-90.
31. Sneed ML, Uhler ML, Grotjan HE, Rapisarda JJ, Lederer KJ, Beltsos AN. Body mass index: impact on IVF success appears age related. Hum Reprod 2008; 23: 1835-39.
32. Chandra A, Stephen EH. Infertility service use among U.S. women: 1995 and 2002. Fertil Steril 2010; 93: 725-36.
33. Greil AL, McQuillan J. Help-seeking patterns among subfecund women. Journal of Reproductive and Infant Psychology 2004; 22: 305-19.
34. Mosalanejad L, Parandavar N, Abdollahifard S. Barriers to infertility treatment: an integrated study. Glob J Health Sci 2013; 6: 181-91.
35. Viau PA, Padula CA, Eddy B. An exploration of health concerns & health-promotion behaviors in pregnant women over age 35. MCN American Journal of Maternal Child Nursing 2002; 27: 328-34.
36. Bunting L, Tsibulsky I, Boivin J. Fertility knowledge and beliefs about fertility treatment: findings from the International Fertility Decision-making Study. Hum Reprod 2013; 28: 385-97.
37. Jansen NA, Saint Onge JM. An internet forum analysis of stigma power perceptions among women seeking fertility treatment in the United States. Soc Sci Med 2015; 147: 184-9.
38. Bunting L, Boivin J. Decision-making about seeking medical advice in an internet sample of women trying to get pregnant. Hum Reprod 2007; 22: 1662-8.
39. Akhondi MM, Ranjbar F, Shirzad M, Behjati Ardakani
Z, Kamali K, Mohammad K. Practical difficulties in estimating the prevalence of primary infertility in Iran. Int J Fertil Steril 2019; 13: 113-7.
40. Dick ML, Bain CJ, Purdie DM, Siskind V, Molloy D, Green AC. Self-reported difficulty in conceiving as a measure of infertility. Hum Reprod 2003; 18: 2711-7.
41. Asser SM, Swan R. Child fatalities from religion-motivated medical neglect. Pediatrics 1998; 101: 625-9.
42. Muramoto O. Recent developments in medical care of Jehovah’s Witnesses. West J Med 1999; 170: 297-301.
43. Sallam HN, Sallam NH. Religious aspects of assisted reproduction. Facts Views Vis Obgyn 2016; 8: 33-48.
44. Datta J, Palmer MJ, Tanton C, Gibson LJ, Jones KG, Macdowall W, et al. Prevalence of infertility and help seeking among 15000 women and men. Hum Reprod 2016; 31: 2108-18.
45. Fujimoto VY, Luke B, Brown MB, Jain T, Armstrong A, Grainger DA, et al. Racial and ethnic disparities in assisted reproductive technology outcomes in the United States. Fertil Steril 2010; 93: 382-90.
46. Shuler A, Rodgers AK, Budrys NM, Holden A, Schenken RS, Brzyski RG. In vitro fertilization outcomes in Hispanics versus non-Hispanic Whites. Fertil Steril 2011; 95: 2735-7.
47. Weinberg CR, Baird DD, Wilcox AJ. Sources of bias in studies of time to pregnancy. Stat Med 1994; 13: 671-81.
| Files | ||
| Issue | Vol 13, No 3 (September 2019) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/jfrh.v13i3.2128 | |
| Keywords | ||
| Pregnancy Infertility Length of Time Pursuing Pregnancy Race Medical Help | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Olig E, Mountan S, Beal J, Sahmoun A. Race and Length of Time Pursuing Pregnancy Among Women Who Utilized Medical Help to Get Pregnant. J Family Reprod Health. 2019;13(3):146-153.
