When do involuntarily infertile couples choose to seek medical help?

OBJECTIVE

To estimate the probability of medical consultation for infertility during the course of a pregnancy attempt and to study its determinants.

DESIGN

Pregnancy-based retrospective telephone survey analyzed with a discrete time Cox model.

SETTING

Two rural counties in Brittany and Normandy, France.

PATIENT(S): A random sample of 901 women from the general population aged 18-60 years reporting 1,460 pregnancy attempts resulting in a live birth between 1985 and 2000 (participation rate, 73%).

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Probability of medical consultation for involuntary infertility cumulated over time.

RESULT(S): The cumulative probability of medical consultation for involuntary infertility among nulligravid women was 45% after 12 months of involuntary infertility and 75% after 24 months. The probability of medical consultation at any time was half that for parous women (odds ratio 0.4, 95% confidence interval 0.2-0.6). More highly educated women were more likely to have sought medical help for infertility. Only 45% of women who had sought medical advice received infertility treatment.

CONCLUSION(S): Our survival approach provides a description of infertility service use during the course of a pregnancy attempt, and confirms that parity and educational level are strong predictors of medical help-seeking behaviors.