title: Association of ethnicity with involuntary childlessness and perceived reasons for infertility: baseline data from the Study of Women's Health Across the Nation (SWAN).
abstract: OBJECTIVE
  To evaluate whether ethnicity is associated with involuntary childlessness and perceived reasons for difficulties in becoming pregnant.
  
  
  METHODS
  Cross-sectional analysis of baseline data from a longitudinal cohort.
  
  
  METHODS
  Multiethnic, community-based observational study of US women.
  
  
  METHODS
  Women in midlife (3,149), aged 42-52 years.
  
  
  METHODS
  None.
  
  
  METHODS
  Involuntary childlessness and perceived etiology of infertility.
  
  
  RESULTS
  One hundred thirty-three subjects (4.2%) were involuntarily childless, defined by a reported history of infertility and nulliparity. Ethnicity was significantly associated with self-reported involuntary childlessness. After controlling for economic and other risk factors, African American (odds ratio [OR] 0.30; 95% confidence interval [CI] 0.15-0.59) and Chinese women (OR 0.36; 95% CI 0.14-0.90) were less likely to suffer from involuntary childlessness compared with non-Hispanic white women. In addition, 302 subjects reported a perceived etiology of infertility. An unexpectedly large proportion of these women (24.5%, 74 of 302) reported etiologies not known to cause infertility (i.e., tipped uterus, ligaments for tubes were stretched), with African American women having been most likely to report these etiologies (OR 2.81; 95% CI 1.26-6.28) as the reason for not becoming pregnant.
  
  
  CONCLUSIONS
  Ethnicity is significantly associated with involuntary childlessness and perceived etiology of infertility. Misattribution of causes of infertility is common and merits further consideration with respect to language or cultural barriers, as well as possible physician misattribution.
authors.affiliation: Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Anatte
authors.initials: A
authors.lastname: Karmon
authors.forename: Susan M
authors.initials: SM
authors.lastname: Hailpern
authors.forename: Genevieve
authors.initials: G
authors.lastname: Neal-Perry
authors.forename: Robin R
authors.initials: RR
authors.lastname: Green
authors.forename: Nanette
authors.initials: N
authors.lastname: Santoro
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Polotsky
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000704:Analysis of Variance; D001213:Asian / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D002681:China / Q000208:ethnology; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007246:Infertility / Q000208:ethnology* / Q000503:physiopathology; D007564:Japan / Q000208:ethnology; D016015:Logistic Models; D008137:Longitudinal Studies; D008875:Middle Aged; D016017:Odds Ratio; D010298:Parity; D010465:Perception; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D016387:Women's Health