title: Risks Factors and Treatment Use Related to Infertility and Impaired Fecundity Among Reproductive-Aged Women.
abstract: Population-level data on infertility and impaired fecundity are sparse. We explored the use of self-reported information provided by reproductive-aged women participating in the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS).
  
  
  
  Three out of 12 questions on reproductive history, family planning, and infertility that seven states included in the 2013 BRFSS were used for this study. In addition to descriptive statistics, we used multinomial logistic regression to identify factors associated with ever experiencing infertility only, difficulty staying pregnant only, and neither infertility nor difficulty staying pregnant. We also explored the association between healthcare coverage and type of treatment received among women ever experiencing infertility only or difficulty staying pregnant only.
  
  
  
  Compared with women reporting having never experienced either infertility or difficulty staying pregnant, women who reported ever experiencing difficulty staying pregnant only were significantly more likely to report a history of depressive disorders and smoking (adjusted odds ratio [aOR] = 1.69, 95% confidence interval [CI] = 1.07-2.68 and aOR = 1.98, 95% CI = 1.22-3.20, respectively). Women who ever experienced infertility only were also more likely to report a history of depressive disorders (aOR = 2.02, 95% CI = 1.14-3.59), but less likely to report healthcare coverage (aOR = 0.26, 95% CI = 0.14-0.46). Only 18.9% (95% CI = 11.4-29.9) of women who ever experienced difficulty staying pregnant only reported seeking infertility treatment compared with 49.6% (95% CI = 34.9-64.4) of women who ever experienced infertility only.
  
  
  
  Ongoing public health surveillance systems of state-specific self-reported data, such as BRFSS, provide the opportunity to explore preventable risk factors and treatment use related to infertility and impaired fecundity.
authors.affiliation: 1 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia .
authors.forename: Sara
authors.initials: S
authors.lastname: Crawford
authors.affiliation: 1 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia .
authors.forename: Ruben A
authors.initials: RA
authors.lastname: Smith
authors.affiliation: 2 Division of Emergency Operations, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention , Atlanta, Georgia .
authors.forename: Sachiko A
authors.initials: SA
authors.lastname: Kuwabara
authors.affiliation: 3 Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention , Atlanta, Georgia .
authors.forename: Violanda
authors.initials: V
authors.lastname: Grigorescu
mesh_terms: D000293:Adolescent; D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D002487:Centers for Disease Control and Prevention, U.S.; D005260:Female; D005298:Fertility; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D011159:Population Surveillance; D011247:Pregnancy; D062486:Public Health Surveillance / Q000379:methods*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D060728:Reproductive Health; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: BRFSS; impaired fecundity; infertility; population-based survey; public health surveillance