Pursuing Treatment for Fertility Problems

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Infertility affects approximately 10%, or 6.1 million married women in the United States (CDC, 2011). African American, Hispanic, and other non-Caucasian women report higher rates of infertility, according to the National Center for Health Statistics (Abma, Chandra, Peterson, & Mosher, 1998). Despite attempts to ensure equal access to care, the majority of women using assisted reproductive technology (ART) services are non-Hispanic Caucasian (85.4%), while 5.4% are Hispanic women, 4.6% are non-Hispanic African American, 4.5% are Asian, and .1% are another ethnicity (Seifer, Frazier, & Grainger, 2008). Women of ethnic minorities, particularly Hispanic and African American women are less likely to receive ART and wait longer before seeking treatment. Factual differences exist in access to and use of infertility treatment by ethnic and cultural minorities in the US; yet, there is little research addressing this issue aside from that which examines financial reasons alone. Increased levels of depression prior to treatment have been correlated with treatment dropout (Eisenberg et al., 2010; Smeenk, Verhaak, Stolwijk, Kremer, & Braat, 2004), which could explain underutilization among minority women. Hypothesized social, cultural or religious barriers could account for this discrepancy as well, although limited literature exists about women’s perception of these perceived barriers.This study aimed to elucidate perceived barriers to care among minority and non-minority women and to examine the association of depression, social support, and these barriers with not pursuing or discontinuing treatment. A sample of 211 women with self-reported fertility problems was recruited from online social media outlets; these women completed a cross-sectional self-report online survey. Study measures included a demographic questionnaire; the Center of Epidemiologic Studies Depression Scale, Revised; the Interpersonal Support Evaluation List; the Measure of Perceived Barriers; and the Intent to Pursue Treatment Measure. Primary hypotheses predicted that social support would moderate the effect of depression on the intent to pursue treatment. Secondary hypotheses examined endorsed barriers, their severity, and the effect these variables had on the intent to pursue treatment. Tertiary hypotheses examined the differences between minority and non-minority women on barriers, severity of barriers, and the pursuit of non-medical treatment options.Results indicated a trend toward significance in the relationship between depression, social support, and the intent to pursue treatment among a subsample of women currently trying to conceive F (2,153) = 2.62, p = .076. Several barriers to care beyond financial burden were endorsed by a majority of women. Multiple linear regression analysis revealed that barrier severity (a = 7.30, b = -.54, SE = .15, t = -3.66, p < .001) was significantly correlated with intent to pursue treatment, while total barriers was not (b = -.02, SE = .03, t = -.77, p = .44). Finally, results supported the premise that minority…