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Objective
To investigate barriers in accessing care for infertility in Mexico, as little is known about this issue for low and middle-income countries, which comprise 80% of the world’s population.
Design
Cross-sectional analysis
Setting
Mexican Teachers’ Cohort
Patients
115,315 female public-school teachers from 12 states in Mexico
Interventions
None
Main Outcome Measures
Participants were asked detailed questions about their demographics, lifestyle characteristics, access to the health care system, and infertility history via a self-reported questionnaire. Log-binomial models, adjusted a priori for potential confounding factors, were used to estimate the prevalence ratios (PR) and 95% confidence intervals (95% CI) of accessing medical care for infertility among women reporting a history of infertility.
Results
19,580 (17%) participants reported a history of infertility. Of those who experienced infertility, 12,470 (63.7%) reported seeking medical care for infertility, among whom 8,467 (67.9%) reported undergoing fertility treatments. Among women who reported a history of infertility, women who taught in a rural school (PR:0.95; 0.92-0.97), spoke an indigenous language (PR:0.88; 0.84-0.92), or had less than a university degree (PR:0.93; 0.90-0.97) were less likely to access medical care for fertility. Women who had ever had a mammogram (PR:1.07; 1.05-1.10), had a pap-smear in the past year (PR:1.08;1.06-1.10), or who had utilized private healthcare regularly or in times of illness were more likely to access medical care for fertility.
Conclusion
Utilization of infertility care varied by demographic, lifestyle, and access characteristics, including speaking an indigenous language, teaching in a rural school, and having a private healthcare provider.
Keywords
Article Info
Publication History
Accepted:
November 21,
2022
Received in revised form:
November 18,
2022
Received:
March 23,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2022 The Authors. Published by Elsevier Inc. on behalf of American Society for Reproductive Medicine.
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