The gender gap in the time costs of infertility treatment: examination of a prospective U.S. cohort

Abstract

OBJECTIVE: In addition to the financial burden placed on couples seeking reproductive assistance, there is also a time cost. While it is generally assumed that both members of an infertile couple share the costs of treatment, less is understood about how the time commitments of infertility services are divided. DESIGN: Prospective U.S. cohort of infertile couples. MATERIALS AND METHODS: Infertile couples were recruited from 8 reproductive endocrinology practices for a longitudinal study of the impact of infertility. From questionnaires; demographic, socioeconomic, and reproductive factors were assessed. Follow up interviews were conducted at 4, 10, and 18 months during which time participants recorded diaries in which they annotated time spent on infertility treatment including clinic visits, travel, telephone, and other tasks. RESULTS: 371 couples completed cost diaries. Mean female age was 35.6 ± 4.8 years, while mean male age was 36.8 ± 5.6 years. Over an 18 month time period, women reported spending significantly more time on infertility related activities (median: 51.5 hours, range: 0 to 537) compared to men (median: 18.5 hours, range: 0 to 265; p<0.01). These differences in time expenditures between genders persisted regardless of infertility diagnosis (p<0.01). When examining women, those from couples with a male factor infertility etiology, reported significantly higher time expenditures (p<0.05). A similar trend toward larger time expenditures was also noted in men from couples with a male factor (p=0.06). In contrast, there was no difference in time expenditures whether a female factor was present among female (p=0.74) or male respondents (p=0.95). CONCLUSION: Women from infertile couples spend significantly more time on on infertility related activities than do their male partners. A diagnosis of male factor infertility significantly increases the time costs for both members of an infertile couple, while female factor infertility has no significant effect on a couple's time expenditures.