Swift Brenna E, Liu Kimberly E
Faculty of Medicine, University of Toronto, Toronto ON.
Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto ON.
J Obstet Gynaecol Can. 2014 Nov;36(11):990-996. doi: 10.1016/S1701-2163(15)30412-6.
An increasing number of Canadian women are delaying child-bearing, despite a decrease in fertility with age. A longer duration of infertility is associated with a significant decrease in live birth rate, reinforcing the need for prompt access to fertility treatment. This study aimed to assess the fertility awareness of women attending a fertility clinic to determine whether fertility awareness is a factor in accessing treatment.
A quantitative cross-sectional survey evaluated fertility awareness and collected information about ethnicity, education level, and the duration of infertility for new patients. Fertility awareness was evaluated with questions about prevalence, causes, and treatment of infertility.
The mean age of participants in the study was 34 years (range 23 to 44; n = 140). The duration of infertility before new patients first sought medical advice for infertility was less than one year in 52.9%, one to two years in 28.6%, two to three years in 12.9%, and four or more years in 5.0% of study participants. Fertility awareness was calculated as the percentage of correct responses to the survey questions. The mean fertility awareness for all study participants was 49.9% and this ranged from the lowest score of 9.1% to the highest score of 90.9% correct. Women waiting for longer than two years to seek medical help had lower fertility awareness (P = 0.038). In addition, fertility awareness was greater in women who had previously sought medical help for infertility from a family doctor, a gynaecologist, or another fertility clinic (P = 0.001). Higher fertility awareness correlated with a higher level of education (linear trend P < 0.001). Finally, fertility awareness also varied with ethnicity (ANOVA P = 0.025), but the age at which women of different ethnicities sought treatment was similar (ANOVA P = 0.13).
Fertility awareness is associated with time to seek treatment, ethnicity, and level of education among new patients seeking medical treatment. This study demonstrates the need to educate women of reproductive age and identifies particular patient populations in Canada that would most benefit from further education about infertility.
尽管随着年龄增长生育能力会下降,但越来越多的加拿大女性推迟生育。不孕持续时间延长与活产率显著降低相关,这强化了及时获得生育治疗的必要性。本研究旨在评估前往生育诊所的女性的生育意识,以确定生育意识是否是影响获得治疗的一个因素。
一项定量横断面调查评估了生育意识,并收集了新患者的种族、教育水平和不孕持续时间等信息。通过关于不孕患病率、原因和治疗的问题来评估生育意识。
研究参与者的平均年龄为34岁(范围23至44岁;n = 140)。在研究参与者中,新患者首次就不孕问题寻求医疗建议之前,不孕持续时间少于一年的占52.9%,一至两年的占28.6%,两至三年的占12.9%,四年或更长时间的占5.0%。生育意识以对调查问题正确回答的百分比来计算。所有研究参与者的平均生育意识为49.9%,正确回答率最低为9.1%,最高为90.9%。等待超过两年才寻求医疗帮助的女性生育意识较低(P = 0.038)。此外,之前曾向家庭医生、妇科医生或其他生育诊所就不孕问题寻求过医疗帮助的女性生育意识更强(P = 0.001)。较高的生育意识与较高的教育水平相关(线性趋势P < 0.001)。最后,生育意识也因种族而异(方差分析P = 0.025),但不同种族女性寻求治疗的年龄相似(方差分析P = 0.13)。
生育意识与寻求治疗的时间、种族以及寻求医疗治疗的新患者的教育水平相关。本研究表明有必要对育龄女性进行教育,并确定加拿大哪些特定患者群体将从关于不孕的进一步教育中获益最大。