title: Infertility evaluation and treatment among women in the United States.
abstract: OBJECTIVE
  To examine the characteristics of women seeking infertility evaluation and treatment.
  
  
  METHODS
  Cross-sectional survey based on in-person interviews, followed by two-step hurdle analysis.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  4,558 married or cohabitating women ages 25 to 44 years.
  
  
  METHODS
  None.
  
  
  METHODS
  Likelihood of seeking a preliminary infertility evaluation and of seeking infertility treatment once evaluated, and the treatment type provided.
  
  
  RESULTS
  Of 623 women (13.7%) who reported seeking an infertility evaluation, 328 reported undergoing subsequent infertility treatment. Age at marriage, marital status, education, health insurance status, race/ethnicity, and religion were associated with the likelihood of seeking infertility evaluation. For example, the predicted probability that a non-white woman who married at age 25 will seek evaluation was 12%. This probability increased to 34% for white women with a graduate degree who had married at age 30. Among women who were evaluated, income, employment status, and ethnicity correlated strongly with the likelihood of seeking infertility treatment. Infertility drug therapy was the most frequent treatment used, and reproductive surgery and in vitro fertilization (IVF) were used the least often.
  
  
  CONCLUSIONS
  The use of infertility services is not random. Understanding the sociodemographic factors correlated with use may assist new couples with family planning. Roughly 50% of the women evaluated for infertility progressed to treatment, and only a small proportion were treated with more advanced assisted reproductive technologies such as in vitro fertilization. Future research aimed at improving access to effective health-care treatments within the boundaries of affordability is warranted.
authors.affiliation: Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, Florida; Department of Economics, College of Arts and Sciences, University of South Florida, Tampa, Florida. Electronic address: lkessler@mail.usf.edu.
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Kessler
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Craig
authors.forename: Shayne M
authors.initials: SM
authors.lastname: Plosker
authors.forename: Damon R
authors.initials: DR
authors.lastname: Reed
authors.forename: Gwendolyn P
authors.initials: GP
authors.lastname: Quinn
mesh_terms: D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D005260:Female; D005298:Fertility; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006297:Health Services Accessibility; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D016017:Odds Ratio; D010043:Outcome and Process Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: Assisted reproduction; family planning; infertility; infertility evaluation; infertility treatment