Cebert-Gaitors Morine, Shannon-Baker Peggy Ann, Silva Susan G, Hart Renee E, Jahandideh Samad, Gonzalez-Guarda Rosa, Stevenson Eleanor L
The University of Pennsylvania, Perelman School of Medicine, the National Clinician Scholars Program, Philadelphia, Pennsylvania.
The Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania.
F S Rep. 2022 Feb 22;3(2 Suppl):29-39. doi: 10.1016/j.xfre.2022.02.004. eCollection 2022 May.
To provide a comprehensive and multidimensional description and conceptualization of the experiences of Black women seeking treatment for infertility.
Convergent parallel mixed-methods study combining retrospective chart review data and semistructured interview data.
Private infertility clinic.
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.
None.
Treatment seeking.
Psychobiological, clinical, and sociocultural factors.
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.
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.
对寻求不孕症治疗的黑人女性的经历进行全面且多维度的描述和概念化。
采用回顾性病历审查数据与半结构化访谈数据相结合的收敛平行混合方法研究。
私立不孕症诊所。
2015年1月至2019年9月期间，在华盛顿特区大都市地区一家不孕症诊所与男性伴侣一同前来进行初次不孕症评估的18至44岁非裔美国/黑人女性。
无。
寻求治疗情况。
心理生物学、临床和社会文化因素。
除了心理生物学、临床和社会文化领域，我们了解到寻求不孕症治疗的黑人女性年龄较大且超重，患有复杂的妇科疾病，并且经历不孕症的时间较长。寻求治疗的延迟可能是由于对不孕症的感知风险较低、对治疗选择的理解不足、初级保健提供者的转诊模式不当以及社会支持有限。此外，黑人女性在寻求治疗方面存在延迟，因为她们在考虑医疗干预之前尝试了基于生活方式的自我干预。促进就医的因素包括心理困扰、复杂的妇科病史以及找到具备文化胜任力的医疗服务提供者。
研究结果表明，美国的黑人女性在医疗服务提供方面容易受到差异对待，尤其是在生殖内分泌领域。我们的研究结果突出了黑人女性在不孕症相关问题的教育、早期识别和早期转诊方面错失机会的领域。未来的研究应致力于在临床和政策层面减少不孕症治疗的障碍。
