Behavior patterns and related factors of seeking infertility health services in China: a cross-sectional study

Abstract

Abstract Background Infertility affects an average of 9% of reproductive-aged couples worldwide. There are still gaps in utilizing infertility health care between regions within China. This study attempts to explore different behavior patterns when people utilize infertility treatment services and related factors. Methods A cross-sectional survey was carried out in 17 Assisted Reproductive Technology clinics in China in 2020. Using two-step cluster analysis, different behavior patterns of health care utilization of infertile women (3507) and men (721) were identified for each sex. Taking cluster membership as the dependent variable, and age, educational level, ethnicity, etc, as the independent variables, univariate analysis and multivariate logistic regression analyses were performed for each sex group separately. Findings: 10.9% of female and 19.3% of male participants had a much longer duration (4-6.9 years) of deciding to take action to seek infertility health care and a longer time (4.5-9 years) in trying to get pregnant. Age (OR 1.128, 95% CI 1.102–1.154 for women and OR 1.082, 95% CI 1.047–1.120 for men), education level (OR 0.360, 95% CI 0.21–0.618 for women and OR 0.193, 95% CI 0.068–0.546 for men), and husband’s annual income (OR 0.545, 95% CI 0.35–0.848 for women and OR 0.585, 95% CI 0.282–1.245 for men) are independent factors associated with the different utilization of health care in China for both infertile women and men. Ethnicity (OR 2.001, 95% CI 1.476–2.713) is a prominent independent factor for infertile women, and obtaining infertility knowledge from doctors (OR 1.882, 95% CI 1.26–2.81) is an independent factor prominent for infertile men in utilizing health care. The female poor utilization group had spent more on treatments, gotten less reimbursement from the health insurance system, and had undergone further treatment regimens. Conclusion There are disparities in utilizing health care for infertility and some people are disadvantaged in obtaining treatment at an optimal age. Certain factors influence individuals’ utilization of infertile healthcare services.