title: Socioeconomic disparities in the use and success of fertility treatments: analysis of data from a prospective cohort in the United States.
abstract: OBJECTIVE
  To determine the effect of income, education, and race on the use and outcomes of infertility care.
  
  
  METHODS
  Prospective cohort.
  
  
  METHODS
  Eight community and academic infertility practices.
  
  
  METHODS
  Three hundred ninety-one women presenting for an infertility evaluation.
  
  
  METHODS
  Face-to-face and telephone interviews and questionnaires.
  
  
  METHODS
  Use of infertility services and odds of pregnancy. Linear and logistic regression used to assess relationship between racial and socioeconomic characteristics, use of infertility services, and infertility outcomes.
  
  
  RESULTS
  After adjustment for age and demographic and fertility characteristics, college-educated couples (β = $5,786) and households earning $100,000-$150,000 (β = $6,465) and ≥$150,000 (β = $8,602) spent significantly more on infertility care than their non-college-educated, lower-income counterparts. Higher income and college-educated couples were much more likely to use more cycles of higher-intensity fertility treatment. The increased cost of infertility care was primarily explained by these differences in number and type of infertility treatment. Even after adjustment for these factors and total amount spent on fertility care, having a college degree was associated with persistently higher odds of achieving a pregnancy (OR = 1.9).
  
  
  CONCLUSIONS
  Education and household income were independently associated with the amount of money spent on fertility care. This relationship was primarily explained by types and intensity of infertility treatments used. Having at least a college degree was independently associated with improved odds of pregnancy.
authors: Department of Urology, University of California, San Francisco, 1600 Divisadero Street, Box 1695, San Francisco, CA 94143-1695, USA. smithjf@urology.ucsf.edu
authors: James F
authors: JF
authors: Smith
authors: Michael L
authors: ML
authors: Eisenberg
authors: David
authors: D
authors: Glidden
authors: Susan G
authors: SG
authors: Millstein
authors: Marcelle
authors: M
authors: Cedars
authors: Thomas J
authors: TJ
authors: Walsh
authors: Jonathan
authors: J
authors: Showstack
authors: Lauri A
authors: LA
authors: Pasch
authors: Nancy
authors: N
authors: Adler
authors: Patricia P
authors: PP
authors: Katz
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