Psychobiological, clinical, and sociocultural factors that influence Black women seeking treatment for infertility: a mixed-methods study.

OBJECTIVE

To provide a comprehensive and multidimensional description and conceptualization of the experiences of Black women seeking treatment for infertility.

DESIGN

Convergent parallel mixed-methods study combining retrospective chart review data and semistructured interview data.

SETTING

Private infertility clinic.

PATIENTS

African American/Black women between 18 and 44 years of age who presented for an initial infertility evaluation with a male partner between January 2015 and September 2019 at an infertility clinic in the metropolitan Washington D.C. area.

INTERVENTIONS

None.

MAIN OUTCOMES

Treatment seeking.

MEASURES

Psychobiological, clinical, and sociocultural factors.

RESULTS

Along with the psychobiological, clinical, and sociocultural domains, we understood that Black women who sought treatment for infertility were older and overweight, had complex gynecological diagnoses, and experienced infertility for long periods of time. The delay in seeking treatment was possibly because of a low perceived risk of infertility, poor understanding of treatment options, inadequate referral patterns of primary care providers, and limited social support. Further, Black women experienced delays in seeking treatment because they attempted lifestyle-based self-interventions before considering medical interventions. Facilitators to care included psychological distress, complex gynecological medical history, and finding culturally competent providers.

CONCLUSIONS

The study findings show that Black women in the United States are vulnerable to disparities in healthcare delivery, especially within reproductive endocrinology. Our findings highlight areas where Black women are experiencing missed opportunities for teaching, early identification, and early referrals for infertility-related concerns. Future studies should seek to reduce barriers to infertility treatment at the clinical and policy levels.