Fertility treatment, use of in vitro fertilization, and time to live birth based on initial provider type
Autor: | Sara E. Simonsen, Mandy Ward Boltz, Jessica N. Sanders, Joseph B. Stanford |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Infertility
Adult medicine.medical_specialty media_common.quotation_subject Population Fertility Fertilization in Vitro Article 03 medical and health sciences 0302 clinical medicine General Practitioners Pregnancy Surveys and Questionnaires medicine Odds Ratio Humans 030212 general & internal medicine education media_common Retrospective Studies education.field_of_study 030219 obstetrics & reproductive medicine business.industry Obstetrics Hazard ratio Public Health Environmental and Occupational Health Retrospective cohort study Odds ratio medicine.disease Time-to-Pregnancy Treatment Outcome Female Family Practice Live birth business Infertility Female Live Birth |
Popis: | Purpose To explore the relationship between the type of clinician (generalist vs subspecialist) initially seen by infertile women, the treatment received, and the time to pregnancy. Methods We analyzed mixed-mode questionnaire data from 867 women with primary infertility enrolled into a retrospective cohort through population- and fertility clinic-based sampling. We compared women presenting first to generalist providers with women presenting first to fertility subspecialists, with the main outcomes of receiving in vitro fertilization (IVF), time to pregnancy, and live birth. Results The first contact for most (84%) women with infertility was a generalist provider. Only 8% of women sought care first from a fertility subspecialist, and these women were older and had been trying longer to conceive. Women who presented first to a generalist provider were less likely to receive IVF (adjusted odds ratio, 0.48; 95% confidence interval, 0.28-0.82), were equally likely to achieve pregnancy, and had similar times to pregnancy (adjusted hazard ratio, 1.11; 95% confidence interval, 0.80-1.53) compared with women who presented first to a subspecialist. Conclusions Generalist providers are frequently the first point of care for women with difficulty conceiving and are uniquely positioned to promote the balanced management of infertility. |
Databáze: | OpenAIRE |
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