Arisa Iba1, Eri Maeda2, Seung Chik Jwa3, Ayako Yanagisawa-Sugita1, Kazuki Saito4, Akira Kuwahara5, Hidekazu Saito6, Yukihiro Terada7, Osamu Ishihara3, Yasuki Kobayashi8. 1. Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. 2. Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan. 3. Department of Obstetrics and Gynecology, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma, Saitama, 350-0495, Japan. 4. Department of Pediatrics, Perinatal, and Maternal Medicine (Ibaraki), Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. 5. Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan. 6. Umegaoka Women's Clinic, 1-33-3 Umegaoka, Setagaya-ku, Tokyo, 154-0022, Japan. 7. Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan. 8. Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. yasukik@m.u-tokyo.ac.jp.
Abstract
BACKGROUND: Fertility treatments help many infertile couples to have children. However, disparities exist in access to fertility tests and treatments. We investigated the association between household income and medical help-seeking for fertility in Japan. METHODS: We conducted a cross-sectional study using nationally representative data from the National Fertility Survey 2015. Respondents were 6598 married women younger than 50 years old. The primary outcome was medical help-seeking for fertility among those who experienced fertility problems. Multiple logistic regression models were used to assess the association between household income and medical help-seeking, adjusting for age, length of marriage, educational level, employment status, number of children, childbearing desires, living with parents, and region of residence. RESULTS: Among 2253 (34%) women who experienced fertility problems, 1154 (51%) sought medical help. The proportion of help-seekers increased linearly from 43% in the low-income group (< 4 million Japanese yen [JPY]) to 59% in the high-income group (≥ 8 million JPY) (P for trend < 0.001). Respondents with upper-middle (6-8 million JPY) or high household income were more likely to seek medical help, compared to those with low household income: adjusted odds ratio [aOR] 1.37 (95% confidence interval [CI]: 1.00-1.86) and aOR 1.78 (95% CI: 1.29-2.47), respectively. CONCLUSIONS: We found that higher household income was associated with a higher probability of seeking medical help among Japanese women who experienced fertility problem. Along with policy discussion about additional financial support, further studies from societal, cultural, or psychological views are required.
BACKGROUND: Fertility treatments help many infertile couples to have children. However, disparities exist in access to fertility tests and treatments. We investigated the association between household income and medical help-seeking for fertility in Japan. METHODS: We conducted a cross-sectional study using nationally representative data from the National Fertility Survey 2015. Respondents were 6598 married women younger than 50 years old. The primary outcome was medical help-seeking for fertility among those who experienced fertility problems. Multiple logistic regression models were used to assess the association between household income and medical help-seeking, adjusting for age, length of marriage, educational level, employment status, number of children, childbearing desires, living with parents, and region of residence. RESULTS: Among 2253 (34%) women who experienced fertility problems, 1154 (51%) sought medical help. The proportion of help-seekers increased linearly from 43% in the low-income group (< 4 million Japanese yen [JPY]) to 59% in the high-income group (≥ 8 million JPY) (P for trend < 0.001). Respondents with upper-middle (6-8 million JPY) or high household income were more likely to seek medical help, compared to those with low household income: adjusted odds ratio [aOR] 1.37 (95% confidence interval [CI]: 1.00-1.86) and aOR 1.78 (95% CI: 1.29-2.47), respectively. CONCLUSIONS: We found that higher household income was associated with a higher probability of seeking medical help among Japanese women who experienced fertility problem. Along with policy discussion about additional financial support, further studies from societal, cultural, or psychological views are required.
Authors: James F Smith; Michael L Eisenberg; David Glidden; Susan G Millstein; Marcelle Cedars; Thomas J Walsh; Jonathan Showstack; Lauri A Pasch; Nancy Adler; Patricia P Katz Journal: Fertil Steril Date: 2011-05-25 Impact factor: 7.329
Authors: Leslie V Farland; Stacey A Missmer; Janet Rich-Edwards; Jorge E Chavarro; Robert L Barbieri; Francine Grodstein Journal: Fertil Steril Date: 2014-04-18 Impact factor: 7.329
Authors: Fernando Zegers-Hochschild; Juan Enrique Schwarze; Javier A Crosby; Carolina Musri; Maria Teresa Urbina Journal: JBRA Assist Reprod Date: 2019-08-22