TY - JOUR
T1 - Accessing medical care for infertility
T2 - a study of women in Mexico
AU - Farland, Leslie V.
AU - Khan, Sana M.
AU - Missmer, Stacey A.
AU - Stern, Dalia
AU - Lopez-Ridaura, Ruy
AU - Chavarro, Jorge E.
AU - Catzin-Kuhlmann, Andres
AU - Sanchez-Serrano, Ana Paola
AU - Rice, Megan S.
AU - Lajous, Martín
N1 - Funding Information:
The authors acknowledge the participants in the Mexican Teachers Cohort study and the National Institute of Public Health of Mexico's research support staff for their time and commitment to advancing the health care of women in Mexico. They thank the Servicio Profesional Docente at the Mexican Ministry of Education, with special thanks to Victor Sastré, Director of Promotion in Service. They also thank all the staff that has participated in questionnaire distribution from the State Ministries of Education of Baja California, Chiapas, Ciudad de México, Durango, Guanajuato, Hidalgo, Jalisco, Estado de México, Nuevo Léon, Sonora, Veracruz, and Yucatan. Finally, they would like to acknowledge ISSSTE, IMSS, ISSSTECali, ISSTELeon, ISSSTESon, ISSTECH, ISSEG, and ISSTEY for their continued support of the project. L.V.F. reports funding from the National Institutes of Health, Centers for Disease Control, and Federal Emergency Management Agency outside the submitted work. J.E.Ch. reports funding from the National Institutes of Health and on Food and Drug Administration; royalties from Harvard Health Publications; honoraria from Johns Hopkins University School of Medicine, National Institutes of Health, Northwestern University Feinberg School of Medicine, Carolinas Medical Center, American Society for Reproductive Medicine, British Dietetic Association, and Pacific Coast Reproductive Society; travel support from Johns Hopkins University School of Medicine, Pacific Coast Reproductive Society, European Society of Human Reproduction and Embryology, Health Sciences University School of Medicine (Colombia), Institut Hospital del Mar d'Investigacions Mediques (Spain), Japanese Society for Reproductive Medicine (Japan), Zhejiang University School of Medicine (China), Lund University Faculty of Medicine (Sweden), Medical University of Vienna (Austria) outside the submitted work. S.A.M. reports funding from AbbVie, NIH, and Marriot Family Foundation; honoraria from University British Columbia, WERF, and Huilun Shanghai; travel support ESHRE 2019 (and 2020 virtual), International Association for the Study of Pain (IASP) 4th World Congress on Abdominal and Pelvic Pain (WCAPP) 2019, National Endometriosis Network UK Meeting 2019, Society for Reproductive Investigation–69th Annual Scientific Meeting (2022), ESHRE 2022, FWGBD 2022, University of Michigan, Massachusetts Institute of Technology; advisory board AbbVie and Roche, field chief editor Frontiers in Reproductive Health, Roundtable participation–Abbott; unpaid leadership roles SWHR, WERF, WES, ASRM, and ESHRE outside the submitted work. S.M.K. has nothing to disclose. D.S. has nothing to disclose. R.L-R. has nothing to disclose. A.C-K. has nothing to disclose. A.P.S-S. has nothing to disclose. M.S.R. is currently an employee of Sanofi and may hold stock/stock options in the company. M.L. reports funding from the National Institutes of Health, the American Institute for Cancer Research, and hte Mexican Council for Science and Technology
Funding Information:
L.V.F. reports funding from the National Institutes of Health, Centers for Disease Control, and Federal Emergency Management Agency outside the submitted work. J.E.Ch. reports funding from the National Institutes of Health and on Food and Drug Administration; royalties from Harvard Health Publications; honoraria from Johns Hopkins University School of Medicine, National Institutes of Health, Northwestern University Feinberg School of Medicine, Carolinas Medical Center, American Society for Reproductive Medicine, British Dietetic Association, and Pacific Coast Reproductive Society; travel support from Johns Hopkins University School of Medicine, Pacific Coast Reproductive Society, European Society of Human Reproduction and Embryology, Health Sciences University School of Medicine (Colombia), Institut Hospital del Mar d’Investigacions Mediques (Spain), Japanese Society for Reproductive Medicine (Japan), Zhejiang University School of Medicine (China), Lund University Faculty of Medicine (Sweden), Medical University of Vienna (Austria) outside the submitted work. S.A.M. reports funding from AbbVie, NIH, and Marriot Family Foundation; honoraria from University British Columbia, WERF, and Huilun Shanghai; travel support ESHRE 2019 (and 2020 virtual), International Association for the Study of Pain (IASP) 4th World Congress on Abdominal and Pelvic Pain (WCAPP) 2019, National Endometriosis Network UK Meeting 2019, Society for Reproductive Investigation–69th Annual Scientific Meeting (2022), ESHRE 2022, FWGBD 2022, University of Michigan, Massachusetts Institute of Technology; advisory board AbbVie and Roche, field chief editor Frontiers in Reproductive Health, Roundtable participation–Abbott; unpaid leadership roles SWHR, WERF, WES, ASRM, and ESHRE outside the submitted work. S.M.K. has nothing to disclose. D.S. has nothing to disclose. R.L-R. has nothing to disclose. A.C-K. has nothing to disclose. A.P.S-S. has nothing to disclose. M.S.R. is currently an employee of Sanofi and may hold stock/stock options in the company. M.L. reports funding from the National Institutes of Health, the American Institute for Cancer Research, and hte Mexican Council for Science and Technology
Publisher Copyright:
© 2022 The Authors
PY - 2023/3
Y1 - 2023/3
N2 - Objective: To investigate barriers in accessing care for infertility in Mexico, because little is known about this issue for low and middle-income countries, which comprise 80% of the world's population. Design: Cross-sectional analysis. Setting: Mexcian Teachers’ Cohort. Patient(s): A total of 115,315 female public school teachers from 12 states in Mexico. Intervention(s): None. Main Outcome Measure(s): The participants were asked detailed questions about their demographics, lifestyle characteristics, access to the health care system, and infertility history via a self-reported questionnaire. Log-binomial models, adjusted a priori for potential confounding factors, were used to estimate the prevalence ratios (PRs) and 95% confidence intervals ( CIs) of accessing medical care for infertility among women reporting a history of infertility. Result(s): A total of 19,580 (17%) participants reported a history of infertility. Of those who experienced infertility, 12,470 (63.7%) reported seeking medical care for infertility, among whom 8,467 (67.9%) reported undergoing fertility treatments. Among women who reported a history of infertility, women who taught in a rural school (PR, 0.95; 95% CI, 0.92–0.97), spoke an indigenous language (PR, 0.88; 95% CI, 0.84–0.92), or had less than a university degree (PR, 0.93; 95% CI, 0.90–0.97) were less likely to access medical care for fertility. Women who had ever had a mammogram (PR, 1.07; 95% CI, 1.05–1.10), had a pap smear in the past year (PR, 1.08; 95% CI, 1.06–1.10), or who had used private health care regularly or in times of illness were more likely to access medical care for fertility. Conclusion(s): The usage of infertility care varied by demographic, lifestyle, and access characteristics, including speaking an indigenous language, teaching in a rural school, and having a private health care provider.
AB - Objective: To investigate barriers in accessing care for infertility in Mexico, because little is known about this issue for low and middle-income countries, which comprise 80% of the world's population. Design: Cross-sectional analysis. Setting: Mexcian Teachers’ Cohort. Patient(s): A total of 115,315 female public school teachers from 12 states in Mexico. Intervention(s): None. Main Outcome Measure(s): The participants were asked detailed questions about their demographics, lifestyle characteristics, access to the health care system, and infertility history via a self-reported questionnaire. Log-binomial models, adjusted a priori for potential confounding factors, were used to estimate the prevalence ratios (PRs) and 95% confidence intervals ( CIs) of accessing medical care for infertility among women reporting a history of infertility. Result(s): A total of 19,580 (17%) participants reported a history of infertility. Of those who experienced infertility, 12,470 (63.7%) reported seeking medical care for infertility, among whom 8,467 (67.9%) reported undergoing fertility treatments. Among women who reported a history of infertility, women who taught in a rural school (PR, 0.95; 95% CI, 0.92–0.97), spoke an indigenous language (PR, 0.88; 95% CI, 0.84–0.92), or had less than a university degree (PR, 0.93; 95% CI, 0.90–0.97) were less likely to access medical care for fertility. Women who had ever had a mammogram (PR, 1.07; 95% CI, 1.05–1.10), had a pap smear in the past year (PR, 1.08; 95% CI, 1.06–1.10), or who had used private health care regularly or in times of illness were more likely to access medical care for fertility. Conclusion(s): The usage of infertility care varied by demographic, lifestyle, and access characteristics, including speaking an indigenous language, teaching in a rural school, and having a private health care provider.
KW - Infertility
KW - access to care
KW - fertility treatment
UR - http://www.scopus.com/inward/record.url?scp=85147125732&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85147125732&partnerID=8YFLogxK
U2 - 10.1016/j.xfre.2022.11.013
DO - 10.1016/j.xfre.2022.11.013
M3 - Article
AN - SCOPUS:85147125732
SN - 2666-3341
VL - 4
SP - 112
EP - 120
JO - F and S Reports
JF - F and S Reports
IS - 1
ER -