The challenge of providing infertility services to a low-income immigrant Latino population.
OBJECTIVE
To provide insight into the experience of low-income immigrant Latino couples seeking infertility treatment.


METHODS
Qualitative interview study.


METHODS
Infertility clinic at a university-affiliated urban public teaching hospital.


METHODS
Infertile low-income immigrant Latino couples (105 women and 40 men).


METHODS
In-depth, tape-recorded interviews.


METHODS
After transcription and translation, the interviews were coded and analyzed for thematic content.


RESULTS
Four major challenges to providing infertility services to this population were identified: [1] communication: language and cultural barriers resulted in patients having difficulty both in understanding diagnoses and treatments and in communicating their questions, concerns, and experiences to physicians; [2] continuity: because medical students and residents rotated frequently, patients usually saw a different physician at each visit; [3] bureaucracy: patients reported having difficulty with appointment scheduling, follow-up visits, and timed laboratory procedures; and [4] accessibility: patients faced issues of limited availability and affordability of treatment.


CONCLUSIONS
At a large, urban, university-affiliated infertility clinic, challenges related to communication, comprehension, continuity, bureaucracy, accessibility, availability, and affordability impeded the delivery of optimal infertility care to many low-income immigrant Latino patients. A greater availability of translators and both patient and physician cultural orientations to address these health care barriers is recommended.
Nachtigall
Robert D
RD
Institute for Health and Aging, University of California-San Francisco, 3333 California Street, San Francisco, CA 94118, USA. Robert.Nachtigall@ucsf.edu
Castrillo
Martha
M
Shah
Nina
N
Turner
Dylan
D
Harrington
Jennifer
J
Jackson
Rebecca
R
D000293:Adolescent; D000328:Adult; D002648:Child; D054242:Emigrants and Immigrants; D005260:Female; D006297:Health Services Accessibility; D006630:Hispanic or Latino; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D007248:Infertility, Male / Q000628:therapy; D007407:Interviews as Topic; D007802:Language; D008297:Male; D008875:Middle Aged; D011203:Poverty; D027724:Reproductive Techniques, Assisted; D012495:San Francisco; D055815:Young Adult