Accessing Medical Care for Infertility: A Study of Women in Mexico

Abstract

AbstractBackgroundInvestigating the burden of access to infertility treatment has primarily been conducted in high-income countries, with little known for low- and middle-income countries, which comprise 80% of the world’s population. The objective of this study was to investigate access to infertility care in Mexico.MethodsThis was a cross-sectional analysis in the Mexican Teachers’ Cohort (MTC), a prospective cohort study of 115,307 Mexican female public school teachers from 12 states in Mexico. Log-binomial models, adjusted for age, hormonal contraceptive use, teaching in a rural school, and speaking an indigenous language, were used to estimate the prevalence ratio (PR) and 95% confidence intervals (95% CI) of accessing medical care for infertility among women reporting a history of infertility.Results19,580 (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.ConclusionUtilization of infertility care varied by demographic and access characteristics, including speaking an indigenous language, teaching in a rural school, and having a private healthcare provider.