Why Not Every Woman Struggling to Get Pregnant Ends up Seeing a Fertility Specialist

Seeing A Fertility Specialist

A new study looks at possible reasons why women having trouble getting pregnant opt to undergo a medical evaluation for infertility. Or why they opt not to.

Fewer than half of U.S. women with fertility problems ever seek medical help to get pregnant or prevent miscarriage, and that proportion has remained pretty steady for years, according to the study authors, who cite federal government data.

You could probably name some of the reasons without even looking at the researchers’ findings:

Women who already had children were less likely to see a fertility specialist than women who didn’t. Older women were less likely to make an appointment than younger women. Women in states that didn’t mandate insurance coverage for infertility treatment were less likely to get an infertility evaluation than women in states that did. Plus, those with a lower household income were less likely to get a workup than wealthier women.

And yet, a few of the factors might surprise you. Smokers were less likely than nonsmokers to have been evaluated. Couch potatoes were less likely to have gotten a fertility workup than women who exercised regularly. And obese women with fertility problems were less likely to see a doctor about it than slim women.

The study focused on female registered nurses who are part of the Nurses’ Health Study II, conducted by researchers at Harvard’s T.H. Chan School of Public Health and Brigham and Women’s Hospital.

The study began in 1989, when the nurses were 25 to 42 years old. Every other year, they’re sent a questionnaire regarding their health and lifestyle. One question, asked on every questionnaire from 1989-2001 and again in 2005 and 2009, was whether they had “tried to become pregnant for more than 1 year without success.”

The 7,442 who answered “yes” were considered to be infertile and were then asked what the cause was. One possible answer was “not investigated,” which was how about a third of the women with infertility answered the question.  Women who reported a cause for their infertility or noted that a cause was “not found” were considered to have had a medical evaluation.

Other factors associated with foregoing a medical evaluation for infertility included having a male partner who did not have a bachelor’s degree– which could be tied to not being able to afford a workup– and, interestingly, not taking multivitamins.

“In conclusion,” the researchers write, “the Centers [for] Disease Control and Prevention has recently stated that the detection of infertility and management of infertility care is a national public health priority.” They said they hoped that their findings might be used to guide efforts to encourage more women to get medical evaluations for infertility.

“This study shows that even with a group whose members have a high degree of medical knowledge and a professional connection to the medical system, there are a host of subtle factors that influence who receives a medical evaluation for infertility and who does not,” Dr. Owen Davis, president of the American Society for Reproductive Medicine, which publishes the scientific journal in which the new research appears, said in a statement.

Have you tried a fertility treatment? Share your thoughts and experiences in the comments section below.

You may also want to read the following related post in Pregistry’s blog: Preparing For an IVF Cycle.

Rita Rubin
An ob-gyn's daughter and the mother of two teenage daughters, Rita Rubin has covered medicine ever since earning a BSJ from Northwestern. Based in Washington, D.C., Rita has written for WebMD, JAMA, POZ, and NBCNews.com and previously worked for USA TODAY. She has won numerous awards for her stories and authored What If I Have a C-Section? Rita earned an MA in writing from Johns Hopkins and spent a year as a fellow at the Harvard School of Public Health. You can follow her on Twitter @RitaRubin.

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