Albert Einstein/Montefiore Medical Center, Bronx, New York.
Albert Einstein/Montefiore Medical Center, Bronx, New York.
Fertil Steril. 2023 Oct;120(4):844-849. doi: 10.1016/j.fertnstert.2023.05.154. Epub 2023 May 22.
To evaluate if language preference influences intrauterine insemination outcomes.
Retrospective cohort.
The study was conducted at an urban medical center in New York from January 2016 to August 2021.
PATIENT(S): All women older than 18 years undergoing their first IUI cycle with an infertility diagnosis were included.
INTERVENTION(S): Intrauterine insemination after ovarian stimulation.
MAIN OUTCOME MEASURE(S): Primary outcomes were intrauterine insemination success rate and duration of infertility before seeking infertility care. The primary outcomes used the Kaplan-Meier estimator to investigate the difference in duration of infertility before specialty consultation and logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) of clinical pregnancy among English speakers vs. those with limited English proficiency (LEP) undergoing initial IUI. Secondary outcomes included final IUI outcomes compared by language preference. Adjusted analyses controlled for race/ethnicity.
A total of 406 patients were included in this study, of which 86% preferred English, 7.6% preferred Spanish, and 5.2% preferred other. Patients with LEP have longer duration of infertility before seeking infertility care than English-proficient women (mean 4.53 ± 3.65 years vs. 2.01 ± 1.58 years). Although clinical pregnancy rate of initial IUI did not significantly vary (OR, 2.92; 95% CI, 0.68-12.47 unadjusted and OR, 2.88; 95% CI, 0.67-12.35 adjusted), the cumulative pregnancy rate was significantly higher in English-proficient patients than in LEP patients at the time of final IUI (22.32% vs. 15.38%). This is despite a similar number of total IUIs (2.40 English vs. 2.70 LEP). Additionally, LEP patients were significantly more likely to discontinue care after unsuccessful IUI, instead of proceeding to further fertility treatments such as in vitro fertilization.
Limited English proficiency is associated with longer duration of infertility before initiating care as well as poorer IUI outcomes, including lower cumulative pregnancy rate. Further research is needed to assess what clinical and socioeconomic factors are contributing to lower IUI success rates and lower continuation in infertility care in LEP patients.
评估语言偏好是否会影响宫腔内人工授精的结局。
回顾性队列研究。
这项研究于 2016 年 1 月至 2021 年 8 月在纽约市的一家城市医疗中心进行。
所有年龄大于 18 岁且因不孕接受首次宫腔内人工授精（IUI）治疗的患者均被纳入研究。
卵巢刺激后的宫腔内人工授精。
主要结局是宫腔内人工授精的成功率和寻求不孕治疗前的不孕持续时间。主要结局使用 Kaplan-Meier 估计器来调查在专科就诊前不孕持续时间的差异，并使用逻辑回归估计在首次接受 IUI 的英语使用者与英语能力有限（LEP）者之间的临床妊娠的优势比（OR）和 95%置信区间（CI）。次要结局包括按语言偏好比较最终 IUI 结局。调整分析控制了种族/民族。
本研究共纳入 406 例患者，其中 86%的患者首选英语，7.6%首选西班牙语，5.2%首选其他语言。LEP 患者在寻求不孕治疗前的不孕持续时间长于英语熟练者（平均 4.53±3.65 年 vs. 2.01±1.58 年）。尽管首次 IUI 的临床妊娠率没有显著差异（未调整的 OR，2.92；95%CI，0.68-12.47 和调整后的 OR，2.88；95%CI，0.67-12.35），但在最终 IUI 时，英语熟练者的累积妊娠率明显高于 LEP 患者（22.32% vs. 15.38%）。这是尽管总宫腔内授精（IUI）次数相似（英语 2.40 次 vs. LEP 2.70 次）。此外，LEP 患者在 IUI 失败后更有可能停止治疗，而不是继续接受体外受精等其他生育治疗。
英语能力有限与开始治疗前不孕持续时间延长以及 IUI 结局较差有关，包括累积妊娠率较低。需要进一步研究评估哪些临床和社会经济因素导致 LEP 患者的 IUI 成功率较低和在不孕治疗中继续治疗的意愿较低。
