1 Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah.
2 Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa.
J Womens Health (Larchmt). 2019 Jan;28(1):63-68. doi: 10.1089/jwh.2017.6731. Epub 2018 Nov 27.
In the general population, infertility is increasingly prevalent in ethnic minority women; these women suffer longer and are less likely to access care. There is a paucity of data regarding the issue of race and infertility in the growing female military veteran population.
This cross-sectional observational study involved computer-assisted telephone interviews of 1,004 Veterans Administration (VA)-enrolled women aged ≤52 years.
Racial minority veterans were more likely than white veterans to self-report infertility (24% vs. 18%), equally likely to report infertility evaluation (52% vs. 52%), and less likely to report receiving infertility treatment (31% vs. 63%). Differences in self-reported infertility (odds ratios [OR]: 1.50, 95% confidence interval [CI]: 1.02-2.22) and infertility treatment (OR: 0.32, 95% CI: 0.13-0.81) were retained after controlling for age, income, marital status, education, insurance, history of pelvic inflammatory disease, and lifetime sexual assault. While racial minority veterans were equally as likely as white veterans to be evaluated for infertility, white and racial minority groups reported different reasons for not seeking evaluation.
Consistent with civilian studies, our data suggest that racial minority VA-enrolled female veterans are more likely to self-report infertility and less likely to receive infertility treatment. Future research should investigate whether these findings are consistent nationwide and regardless of VA enrollment, and if minority veterans have unique barriers to care. A better understanding of how the VA might improve awareness of infertility evaluation and treatment options, especially for racial minority veterans, is needed.
在普通人群中，少数民族女性的不孕不育症越来越普遍；这些女性就诊时间更长，获得治疗的机会也更少。在不断增长的女性退伍军人群体中，关于种族和不孕不育问题的数据很少。
本横断面观察性研究通过计算机辅助电话访谈了 1004 名年龄≤52 岁的退伍军人管理局（VA）登记女性。
少数民族退伍军人自我报告不孕不育的比例（24%比 18%）高于白人退伍军人，报告不孕不育评估的比例（52%比 52%）相当，接受不孕不育治疗的比例（31%比 63%）较低。调整年龄、收入、婚姻状况、教育程度、保险、盆腔炎病史和终生性侵犯后，自我报告不孕不育（优势比 [OR]：1.50，95%置信区间 [CI]：1.02-2.22）和不孕不育治疗（OR：0.32，95% CI：0.13-0.81）的差异仍然存在。尽管少数民族退伍军人与白人退伍军人接受不孕不育评估的可能性相当，但白人和少数民族群体报告的不寻求评估的原因不同。
与平民研究一致，我们的数据表明，VA 登记的少数民族女性退伍军人更有可能自我报告不孕不育，接受不孕不育治疗的可能性较低。未来的研究应调查这些发现是否在全国范围内一致，无论是否在 VA 登记，以及少数民族退伍军人是否存在独特的护理障碍。需要更好地了解 VA 如何提高对不孕不育评估和治疗选择的认识，特别是对少数民族退伍军人。
