Infertility service use among U.S. women: 1995 and 2002

Abstract

Objective: To examine trends in use of medical services for infertility, by individual characteristics of women.

Design: Pooled data from two cycles (1995 and 2002) of the National Survey of Family Growth, a periodically conducted, nationally representative, cross-sectional survey of women 15-44 years of age.

Participant(s): The analysis sample was composed of 2,005 women 22-44 years of age with current fertility problems.

Intervention(s): None.

Main outcome measure(s): Ever having used infertility services, and highest level of services used.

Result(s): Between 1995 and 2002, ever-use of infertility services by fertility-impaired women age 22-44 years continued to be closely associated with older age, nulliparity, formal marital status, and higher socioeconomic status (education, household income, and private health insurance). Net of these factors, race and Hispanic origin, showed no significant association with either the use of services overall or the highest level of services used. After controlling for compositional changes in these individual characteristics, a slight decline was seen in ever-use of services overall from 1995 to 2002. No effect of survey year was noted in the highest level of services.

Conclusion(s): Infertility service use among fertility-impaired women remains closely tied with socioeconomic factors. The "threshold effect" of these factors has shifted upward to the receipt of more costly services such as assisted reproductive technologies. These higher level services remain a relatively small fraction of the services reported in a general population sample of fertility-impaired women.