Infertility in Aboriginal and Torres Strait Islander people: A cause for concern?

Gilbert, Emily W.; Boyle, Jacqueline; Campbell, Sandra; Rumbold, Alice

doi:10.1111/ajo.13158

Cited by 4 publications

(10 citation statements)

References 15 publications

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“…After screening the titles and abstracts, 19 articles fulfilled the inclusion criteria. Full‐text screening identified only 11 papers dealing with the subject of the review 7,8,14‐22 . See Table 1.…”

Section: Resultsmentioning

confidence: 99%

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A silent burden—prolapse, incontinence, and infertility in Australian Aboriginal and Torres Strait Islander women: A systematic search and narrative review

Clarke

Whitson

Williams

et al. 2021

Intl J Gynecology & Obste

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Background Pelvic organ prolapse (POP), urinary incontinence, and infertility are all prevalent conditions associated with considerable reduction in quality of life. As a group, Aboriginal and Torres Strait Islander women may be at higher risk of these conditions, but studies are scarce. Objective To review the literature pertaining to the epidemiology, diagnosis, and management of these conditions in Indigenous Australian women. Search strategy Medline, Embase, and Scopus were searched for articles published between 1980 and 2021 pertaining to these conditions in Indigenous Australian women. Selection criteria Studies that did not directly address the epidemiology, diagnosis, and management of these conditions were excluded. Main results It was possible to identify only 11 papers dealing with these conditions in Indigenous Australian women. Only one dealt with POP and was a retrospective audit of a health outreach program in the Northern Territory concluding that there was significant underreporting of the condition. Five papers dealt with urinary incontinence and, again, described significant underreporting and poor referral pathways. Five papers reported small studies about infertility, one reporting poor engagement from clinical directors. Conclusion It was concluded that despite the importance of these conditions, there is almost no body of research and this is an urgent national problem.

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Section: Resultsmentioning

confidence: 99%

“…The same group, Gilbert and colleagues, 8 also wrote an opinion piece in the same issue, on infertility in Aboriginal and Torres Strait Islander people. They concluded that Indigenous Australians are disproportionately affected by a range of risk factors for infertility including sexually transmitted infections, PCOS, and obesity.…”

Section: Resultsmentioning

confidence: 99%

A silent burden—prolapse, incontinence, and infertility in Australian Aboriginal and Torres Strait Islander women: A systematic search and narrative review

Clarke

Whitson

Williams

et al. 2021

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

“…This may be compounded by a reliance on total fertility rate (TFR) as a measure of infertility. The latest national data indicate that the TFR is slightly higher among Aboriginal and Torres Strait Islander women than in the total Australia population; however, this may conceal important differences in rates of secondary infertility 15–17 …”

Section: Discussionmentioning

confidence: 99%

“…The latest national data indicate that the TFR is slightly higher among Aboriginal and Torres Strait Islander women than in the total Australia population; however, this may conceal important differences in rates of secondary infertility. [15][16][17] Anecdotally, our own clinical experiences (J.B.) and informal discussions with Aboriginal Community Controlled Services 18…”

Section: Discussionmentioning

confidence: 99%

Provision of assisted reproductive technologies (ART) to Aboriginal and Torres Strait Islander peoples: Limited engagement in an online survey of Medical Directors of ART services

Gilbert

Boyle

Campbell

et al. 2020

Aust NZ J Obst Gynaeco

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Current knowledge about infertility and access to infertility treatment among Aboriginal and Torres Strait Islander peoples is extremely limited. We conducted an online survey of Medical Directors of registered ART providers in Australia (n = 59) to obtain preliminary information on this topic. Six (10%) Directors responded; only two reported routinely collecting the Aboriginal and Torres Strait Islander status of clients. While the low response rate prevents generalising the findings, the poor engagement may indicate gaps in awareness of fertility issues for this group. This warrants further investigation, to understand whether Aboriginal and Torres Strait Islander people are appropriately accessing infertility care.

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“…Despite evidence of elevated risk of infertility, national figures show a higher total birth rate and a younger median age of giving birth for Aboriginal and Torres Strait Islander women compared to all Australian women (2.3 births per woman compared with 1.9 per woman) [ 14 ]. This incongruence between suspected and actual prevalence of infertility for Aboriginal and Torres Strait Islander people raises concerns that the relatively high birth rate could mask significant rates of infertility, with those affected remaining largely undiagnosed and untreated [ 18 ]. This may in part reflect the fact Aboriginal and Torres Strait Islander people have poorer access to and use of mainstream health services, due to barriers such as geographic isolation, the high cost of health care, culture and language differences, and experiences of racism and discrimination [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

“We are only looking at the tip of the iceberg in infertility”: perspectives of health providers about fertility issues and management among Aboriginal and Torres Strait Islander people

Gilbert

Walker

Simon

et al. 2021

BMC Health Serv Res

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Introduction Aboriginal and Torres Strait Islander women and men are disproportionately affected by a range of risk factors for infertility. However, remarkably little is known about the prevalence of infertility in this group, or how Aboriginal and Torres Strait Islander people access fertility treatments including assisted reproductive technology (ART). This qualitative study aims to explore health care provider (HCP) perspectives on the health burden of infertility among Aboriginal and Torres Strait Islander people, as well as factors that may affect access to infertility treatment for this group. Method Semi-structured interviews were conducted with HCPs (8 doctors; 3 nurses and 1 Aboriginal Health Practitioner) working in fertility care in the Northern Territory, Australia. Transcribed interviews were analysed using an iterative thematic approach using the NVivo-9 software package. Results Providers perceive infertility as an underestimated health issue in this patient population, reporting a high prevalence of infertility-related risk factors but fewer clinical encounters of diagnosis and treatment. Perceived barriers to accessing fertility care included cultural differences such as the shame and stigma associated with reproductive health and the separation of men’s business and women’s business; service-related barriers such as limited timely and affordable access to specialist health services and; a lack of culturally responsive and appropriate fertility services. Providers had mixed opinions on their role in ameliorating inequities of access, and hence a range of strategies to address barriers were suggested. These included a greater patient education, ongoing patient support and providing a culturally safe environment. Conclusion The current study adds to the understanding of how Aboriginal and Torres Strait Islander people access fertility treatments. There is a need for further research to quantify infertility in Aboriginal and Torres Strait Islander people, investigate community perceptions towards infertility and identify community-driven priorities to improve access to fertility care for this population.

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Infertility in Aboriginal and Torres Strait Islander people: A cause for concern?

Cited by 4 publications

References 15 publications

A silent burden—prolapse, incontinence, and infertility in Australian Aboriginal and Torres Strait Islander women: A systematic search and narrative review

A silent burden—prolapse, incontinence, and infertility in Australian Aboriginal and Torres Strait Islander women: A systematic search and narrative review

Provision of assisted reproductive technologies (ART) to Aboriginal and Torres Strait Islander peoples: Limited engagement in an online survey of Medical Directors of ART services

“We are only looking at the tip of the iceberg in infertility”: perspectives of health providers about fertility issues and management among Aboriginal and Torres Strait Islander people

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