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Research ArticleOriginal Research

Fertility Treatment, Use of in Vitro Fertilization, and Time to Live Birth Based on Initial Provider Type

Mandy W. Boltz, Jessica N. Sanders, Sara E. Simonsen and Joseph B. Stanford
The Journal of the American Board of Family Medicine March 2017, 30 (2) 230-238; DOI: https://doi.org/10.3122/jabfm.2017.02.160184
Mandy W. Boltz
From the College of Medicine, University of Arizona, Phoenix, AZ (MWB); and the Department of Family and Preventive Medicine, Office of Cooperative Reproductive Health, University of Utah, Salt Lake City (JNS, SES, JBS).
MD, MPH
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Jessica N. Sanders
From the College of Medicine, University of Arizona, Phoenix, AZ (MWB); and the Department of Family and Preventive Medicine, Office of Cooperative Reproductive Health, University of Utah, Salt Lake City (JNS, SES, JBS).
PhD, MSPH
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Sara E. Simonsen
From the College of Medicine, University of Arizona, Phoenix, AZ (MWB); and the Department of Family and Preventive Medicine, Office of Cooperative Reproductive Health, University of Utah, Salt Lake City (JNS, SES, JBS).
PhD, CNM
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Joseph B. Stanford
From the College of Medicine, University of Arizona, Phoenix, AZ (MWB); and the Department of Family and Preventive Medicine, Office of Cooperative Reproductive Health, University of Utah, Salt Lake City (JNS, SES, JBS).
MD, MSPH
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Article Figures & Data

Figures

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    Figure 1.

    Provider types and outcomes.

  • Figure 2.
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    Figure 2.

    Time to pregnancy leading to live birth. CI, confidence interval.

Tables

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    Table 1.

    Participant Characteristics

    Population Cohort (n = 434)Clinic Cohort (n = 433)Combined Cohorts (n = 867)
    No.%No.%No.%
    Household income
        <$12,0008241121
        -$12,001-$25,000205143344
        -$25,001-$50,00012930872021625
        -$50,001-$75,000159371242928333
        -$75,001-$100,00067151082517520
        >$100,000358761811113
        No answer164205364
    Insurance coverage for infertility testing and/or treatment
        None, unsure, or no answer310713588366877
        Some coverage other than IVF11126621417320
        IVF coverage133133263
    Religious preference
        None389379759
        Latter-Day Saint343793197466276
        Catholic61174233
        Other Christian215409617
        Other non-Christian133102233
        No answer133102233
    Religious attendance
        Never5813461110412
        Monthly or less5613631511914
        Weekly or more310713157362572
        No answer10292192
    Body mass index (kg/m2)
        <25194452064840046
        25–3010725972220424
        >309722942219122
        No answer368368728
    Age (years) at beginning of first attempt to conceive
        <25274632014647555
        25–30141321613730235
        >3019467158610
        No answer004140
    Age (years) at first infertility visit
        <25151351453329634
        25–30173401683934139
        >303581122614717
        Not applicable or no answer7517828310
    Cumulative months attempting to conceive before first infertility visit
        ≤11125291563628132
        12–23156361904434640
        24–3547114198810
        >363174210738
        Not applicable or no answer751741799
    • IVF, in vitro fertilization.

    • View popup
    Table 2.

    Association between Select Characteristics and Likelihood of Seeing a Fertility Subspecialist First

    General Provider FirstFertility Specialist FirstRelative Risk of Seeing a Fertility Specialist First (95% CI)
    No.%No.%
    Overall73292678—
    Recruitment method
        General population34694226ref.
        Fertility clinic3869045101.74 (1.07–2.85)
    Household income
        ≤$50,00021894146ref.
        -$50,001-$75,000241922181.32 (0.69–2.55)
        >$75,0002439028101.71 (0.92–3.17)
    Insurance coverage for infertility testing and/or treatment
        None or unsure54691549ref.
        Some coverage other than IVF161931270.77 (0.42–1.41)
        IVF coverage2596140.43 (0.06–2.97)
    Religious preference
        None5688813ref.
        Latter-day Saint570924780.61 (0.30–1.23)
        Other than Latter-day Saint868911110.91 (0.39–2.13)
    Religious attendance
        Never8390910ref.
        Monthly or less9592880.79 (0.32–1.97)
        Weekly or more537924980.85 (0.43–1.68)
    Body mass index (kg/m2)
        <2533791329ref.
        25–30176931370.79 (0.43–1.47)
        >30159911691.05 (0.59–1.87)
    Age (years) at beginning of first attempt to conceive
        <2540693297ref.
        25–30251912691.41 (0.85–2.34)
        >30718612142.17 (1.15–4.07)
    Age (years) at first infertility visit
        <2527994176ref.
        25–30316932571.27 (0.70–2.32)
        >301238424162.84 (1.58–5.12)
    Cumulative months attempting to conceive before first infertility visit
        ≤1126695155ref.
        12–233119035101.89 (1.06–3.39)
        ≥241459016101.86 (0.95–3.66)
    • Bolded values in RR (95% CI) are those which are statistically significant.

    • CI, confidence interval; IVF, in vitro fertilization; ref., reference category.

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The Journal of the American Board of Family     Medicine: 30 (2)
The Journal of the American Board of Family Medicine
Vol. 30, Issue 2
March-April 2017
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Fertility Treatment, Use of in Vitro Fertilization, and Time to Live Birth Based on Initial Provider Type
Mandy W. Boltz, Jessica N. Sanders, Sara E. Simonsen, Joseph B. Stanford
The Journal of the American Board of Family Medicine Mar 2017, 30 (2) 230-238; DOI: 10.3122/jabfm.2017.02.160184

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Fertility Treatment, Use of in Vitro Fertilization, and Time to Live Birth Based on Initial Provider Type
Mandy W. Boltz, Jessica N. Sanders, Sara E. Simonsen, Joseph B. Stanford
The Journal of the American Board of Family Medicine Mar 2017, 30 (2) 230-238; DOI: 10.3122/jabfm.2017.02.160184
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Keywords

  • Fertilization; Fertilization in Vitro; Infertility
  • Female; Live Birth; Point-of-Care Systems; Pregnancy; Retrospective Studies; Surveys and Questionnaires; Time-to-Pregnancy

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