Abstract
Aims: The aim of the study was two-fold: i) to determine the prevalence of medical care contact for infertility in European countries; ii) to map overall and long-term/chronic medication use during pregnancy in women who sought medical care due to infertility.Methods: This is a sub-study of the Multinational Medication Use in Pregnancy Study, a cross-sectional, web-based study conducted from October 2011 to February 2012. We included 8097 participants from Europe who were pregnant or new mothers. We collected data on overall and long-term/chronic medication use, medical care seeking due to infertility, and whether women eventually conceived spontaneously or with the aid of infertility treatment.Results: Medical care contact for infertility was lower in Western Europe (prevalence estimate: 10.0-15.3%), compared with Northern (15.2-17.5%) or Eastern (17.4-20.9%), but Poland had the lowest estimate (8.0%). Overall, 660 (8.2%) women sought medical care due to infertility but conceived spontaneously; 548 (6.8%) conceived aided by fertility treatment, and 6889 (85.0%) women did not seek help. Use of any medication was comparable across the three groups (range 80.4-82.5%), but women seeking help for infertility (21.8-24.6%) took more often long-term/chronic medications than women who did not (14.8%).Conclusion: Medical care contacts for infertility varies greatly across European countries. Women who had medical contact due to infertility used more often chronic medications in pregnancy than women who did not, pointing to more co-morbidities and risk pregnancies.
Highlights
Infertility represents a worldwide public health concern
The largest proportion of women who conceived with the aid of fertility treatment ranged between 6.1% and 8.3% in most countries, but was lowest in Poland and the UK (4.1-4.3%) and highest in Slovenia (12.1%)
Because data were collected uniformly across countries, our estimates of medical care contact due to infertility are more comparable across countries in Europe, which is important from a public health perspective, and in relation to access to care
Summary
Infertility represents a worldwide public health concern. Equal and equitable access to fertility care remains a challenge in most countries, in those with low-middle income [1]. Pooled data from worldwide surveys show a 12-month prevalence of infertility between 3.5-16.7% in more developed countries, and 6.9-9.3% in less developed countries [2]. One study showed that 12.7% of women undergoing fertility treatment filled at least one prescription for potential hazardous medications within 45 days after the beginning of a fertility cycle, compared to 6.8% of women who conceived spontaneously [3]. These two groups had comparable intake of periconception folic acid, that is about 30%, which is surprisingly low [3]
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