Association of ethnicity with involuntary childlessness and perceived reasons for infertility: baseline data from the Study of Women’s Health Across the Nation (SWAN)

Abstract

Objective To evaluate whether ethnicity is associated with involuntary childlessness and perceived reasons for difficulties in becoming pregnant . Design Cross-sectional analysis of baseline data from a longitudinal cohort Setting Multiethnic, community-based observational study of US women Patient(s) 3149 midlife women, aged 42-52 Main Outcome Measure(s) Involuntary childlessness and perceived etiology of infertility Result(s) One hundred and thirty-three subjects (4.2%) were involuntarily childless, defined by a reported history of infertility and nulliparity. Ethnicity was significantly associated with self-reported involuntary childlessness. After controlling for economic and other risk factors, African-American (OR 0.30; 95% CI 0.15 – 0.59) and Chinese women (OR 0.36; 95% CI 0.14 – 0.90) were less likely to suffer from involuntary childlessness as compared to non-Hispanic Caucasian women. Additionally, 302 subjects reported a perceived etiology of infertility. An unexpectedly large proportion of these women (24.5%, 74 out of 302) reported etiologies not known to cause infertility (i.e. tipped uterus, ligaments for tubes were stretched), with African-American women having been most likely to report these etiologies (OR 2.81; 95% CI 1.26 – 6.28) as the reason for not becoming pregnant. Conclusion(s) Ethnicity is significantly associated with involuntary childlessness and perceived etiology of infertility. Misattribution of causes of infertility is common and merits further consideration with respect to language or cultural barriers as well as possible physician misattribution.

The Effect of Age, Ethnicity, and Level of Education on Fertility Awareness and Duration of Infertility

“…These results are consistent with those of a study by Karmon et al, in which 25% of women reported perceived etiologies for infertility that are not known to cause infertility. 20 African-American women were more likely to report incorrect etiologies for infertility than Chinese or non-Hispanic white women. 20 A large multi-national study also demonstrated increased knowledge of fertility in countries with a very high human development index.…”

“…20 African-American women were more likely to report incorrect etiologies for infertility than Chinese or non-Hispanic white women. 20 A large multi-national study also demonstrated increased knowledge of fertility in countries with a very high human development index. 3 The age of women seeking fertility treatment was similar among all ethnicities, with women of African descent tending to be younger.…”

Influence of race/ethnicity on prevalence and presentation of endometriosis: a systematic review and meta‐analysis

“…An initial query yielded 1180 studies, subsequently narrowed to 20 studies in the qualitative review 4,[13][14][15][16][17][18][23][24][25][26][27][28][29][30][31][32][33][34][35][36] (Supporting Information Figure S1). An overview of the included studies' characteristics and primary outcomes is given in Table 1.…”

Young women’s intentions to delay childbearing: A test of the theory of planned behaviour

“…Women who embark on motherhood at older ages have a shorter timespan within which to complete their families, and therefore most often have fewer children (Milan, 2013). Further, postponing childbearing into the period where a woman's fertility is naturally declining can result in conception difficulties, unanticipated infertility, and involuntary childlessness (Balasch & Gratacos, 2012;Karmon et al, 2011). These outcomes combine to have a net negative effect on the national fertility rate.…”