Use of fertility treatment modalities in a large United States cohort of professional women
Open accessAbstract
Objective To evaluate the use of fertility treatments among a large cohort of women in the United States.Design Cohort study.Setting Nurses' Health Study II.Patient(s) Ten thousand thirty-six women who reported having used fertility treatment on biennial questionnaires from 1993-2009.Intervention(s) None.Main outcome measure(s) Data on patterns of treatment modality were collected via self-report from validated mailed questionnaires. Information on clomiphene, gonadotropin injections alone, and gonadotropin injections as part of intrauterine insemination (IUI) and in vitro fertilization (IVF) was queried.Result(s) Most women who reported fertility treatment used clomiphene (94%), with a large majority reporting clomiphene as their only form of treatment (73%). Of women who reported treatment more advanced than clomiphene, 13% had used gonadotropin injections alone, 11% IUI treatment, and 11% IVF. Several subgroups were more likely to use multiple treatment modalities and to initiate treatment with gonadotropins rather than clomiphene, including women living in states with insurance coverage of fertility procedures, with higher household income, younger in age, who remained nulliparous at the study close, and treated after 2000.Conclusion(s) Results should be interpreted cautiously, but to our knowledge, this represents the first study of fertility treatment patterns in the United States and could inform public health planning.
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In a validation study of 44 participants, all medical records that provided information on fertility treatment (74% of records) confirmed women's reported treatment.
“In a validation study, we obtained medical records regarding fertility from 44 participants (with their signed permission); all of the records which provided information on fertility treatment (74% of the records) confirmed women’s reported treatment, while the remaining records generally contained no information on specific treatments and thus were difficult to interpret.(19)”
From Infertility, fertility treatment, and risk of hypertension (2015) · cites this paper as [19]
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- Authors
- Farland, L. V., Missmer, S. A., Rich-Edwards, J., Chavarro, J. E., Barbieri, R. L., & Grodstein, F.
- Affiliations
- Harvard University (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Farland, Leslie V.
- ORCID
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2014-06
- Volume
- 101
- Issue
- 6
- Pages
- 1705-1710
- ISSN
- 0015-0282 (ISSN-L)
- PMC
- PMC4041846
- OpenAlex
- W2123903471
- Cited by
- 27
- References
- 12
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2022: 1 · 2021: 5 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 1 · 2015: 3 · 2014: 1
- FWCI
- 2.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (UM1CA176726)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD59955, R21HD059955, T32HD060454)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- infertility treatment, treatment patterns, clomiphene citrate, gonadotropin injection, intrauterine insemination, in vitro fertilization, professional women, household income, nulliparity, Nurses' Health Study II
- MeSH terms
- Adult, Age Factors, Clomiphene, Combined Modality Therapy, Female, Fertility, Fertility Agents, Female, Fertilization in Vitro, Financing, Personal, Gonadotropins, Humans, Income, Infertility, Female, Insemination, Artificial, Nurses, Parity, Pregnancy, Surveys and Questionnaires, United States, Drug Utilization Review, Insurance Coverage, Health Care Surveys, Reproductive Techniques, Assisted
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