Concerns about treatment for infertility in a probability-based sample of US women

Objective: Many women experience infertility as distressing, but only about half of US women seek medical services. It is unknown whether concerns about fertility treatment are related to receiving fertility treatment or to distress levels. Methods: Using the nationally representative National Survey of Fertility Barriers, we constructed a nine-item scale measuring fertility treatment concerns. The analytical sample for this study included 1218 women who said that they were trying to become pregnant and who were asked questions regarding treatment concerns. We conducted multiple regression analysis to discover factors associated with treatment concerns and whether treatment concerns were associated with depressive symptoms and fertility-specific distress. We used logistic regression to determine whether treatment concerns were associated with receiving fertility tests. Results: Desiring a(nother) child, infertility stigma, higher family income, higher economic hardship and claiming a Hispanic identity were associated with higher levels of treatment concerns than those in the comparison groups. Having friends and family with children and having private health insurance were associated with lower levels of concern. Treatment concerns were not associated with receiving fertility tests. Higher levels of treatment concern were associated with higher levels of fertility-specific distress and depressive symptoms. Higher infertility stigma was related both directly and indirectly to higher levels of fertility-specific distress and depressive symptoms. Conclusion: For US women, fertility treatment concerns are not associated with whether women pursue fertility testing, but they are associated with higher levels of fertility-specific and general distress.