When do involuntarily infertile couples choose to seek medical help?
OBJECTIVE
To estimate the probability of medical consultation for infertility during the course of a pregnancy attempt and to study its determinants.


METHODS
Pregnancy-based retrospective telephone survey analyzed with a discrete time Cox model.


METHODS
Two rural counties in Brittany and Normandy, France.


METHODS
A random sample of 901 women from the general population aged 18-60 years reporting 1,460 pregnancy attempts resulting in a live birth between 1985 and 2000 (participation rate, 73%).


METHODS
None.


METHODS
Probability of medical consultation for involuntary infertility cumulated over time.


RESULTS
The cumulative probability of medical consultation for involuntary infertility among nulligravid women was 45% after 12 months of involuntary infertility and 75% after 24 months. The probability of medical consultation at any time was half that for parous women (odds ratio 0.4, 95% confidence interval 0.2-0.6). More highly educated women were more likely to have sought medical help for infertility. Only 45% of women who had sought medical advice received infertility treatment.


CONCLUSIONS
Our survival approach provides a description of infertility service use during the course of a pregnancy attempt, and confirms that parity and educational level are strong predictors of medical help-seeking behaviors.
Moreau
Caroline
C
Inserm, Institut National de la Santé et de la Recherche Médicale, Unit 822, Epidemiology, Demography, and Social Sciences, Le Kremlin-Bicêtre, France. caroline.moreau@inserm.fr
Bouyer
Jean
J
Ducot
Béatrice
B
Spira
Alfred
A
Slama
Rémy
R
D000028:Abortion, Induced / Q000706:statistics & numerical data; D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D002755:Choice Behavior; D003625:Data Collection; D004522:Educational Status; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007246:Infertility / Q000453:epidemiology* / Q000628:therapy*; D009313:National Health Programs / Q000706:statistics & numerical data; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012017:Referral and Consultation / Q000706:statistics & numerical data; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult