Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

The prevalence of prior infertility in recent mothers

The prevalence of prior infertility in recent mothers Centre for the Study of Mothers’ and Children’s Health, La Trobe Universitx Victoria Accurate, population-based data on the prevalence of infertility is necessary to provide a basis from which to make informed policy, service planning and resource allocation decisions. However, very little is known about the underlying prevalence of infertility in the Australian community.’ Measuring the prevalence of infertility is complex and includes a number of difficulties, such as how to define and measure infertility and how to select an appropriate study population.The most commonly used definition of infertility is a failure to conceive after 12 months regular, unprotected intercourse. Some investigators have measured the proportion of women with infertility at a particular point in time, giving estimates of ‘current infertility’ of between 3.5%’ and 15.8%.2Other investigators have measured the proportion who have had a period of infertility some time during their reproductive life, giving estimates of 14.1 %3 to 26.4%.4 An alternative approach is to investigate the prevalence of prior infertility among a group of women who have recently given Although this approach excludes infertile women who have not become pregnant, it includes all women giving birth after a period of infertility and enables birth outcomes to be studied. Comparing women with and without prior infertility is of importance, because some studies (mainly using clinic-based samples) have suggested that maternal characteristics, and birth and perinatal outcomes may differ between these groups of women. Studies conducted overseas have indicated that less than half the women who reported difficulty conceiving sought medical treatment.’,’ The Survey of Recent Mothers was designed to investigate the experiences and views of Victorian women who had given birth during a two-week period in 1993. Infertility was one of a range of issues the survey investigated. Two questions in the survey asked about infertility. The first asked, “When you became pregnant with the baby you had in September, had you been trying to get pregnant for more than 12 months?’ Women who responded yes to this question were asked “If yes, did you have any treatment to help you get pregnant?’ The response rate was 62.5% (1,336/2,138). A detailed description of the study methodology is available e l ~ e w h e r e . ~ One hundred and twenty-eight (9.6%, 95% CI 8%-11.2%) women reported they had been trying to get pregnant for more than 12 months. Six (0.4%) women did not respond to this question. Forty (31.3%) of the 128 women who reported prior infertility had received treatment for infertility. Of these, 24 had taken fertility drugs to induce ovulation (one received treatment for endometriosis, in addition to ovulation induction), six had conceived using assisted reproductive technologies (ART), five had treatment for endometriosis, four did not specify what type of treatment they had received and one woman conceived after surgery. Three women (2.3%) did not indicate whether they had had treatment. Twenty-five per cent of women with prior infertility were 35 years (of age) or older at the time of the birth, compared with 10.8% of women not experiencing a period of infertility prior to the birth (OR 2.74, 95% CI 1.7-4.3). Women with prior infertility were more likely to give birth by caesarean section (OR 1.98,95% CI 1.3-3.0). They were not significantly more likely to have had their labour induced or augmented, nor were they significantly more likely to give birth to a preterm (<37 weeks gestation) or low birth weight infant ( ~ 2 , 5 0 0 grams). Just under 10% of women in this population-based sample had experienced a period of infertility prior to conception. Other studies have reported the prevalence of prior infertility among women who have recently given birth as 7.8%5 and 17.8%.6 The finding adds to a small body of population-based data on the prevalence of infertility in Australia. The characteristics of respondents to our survey (62.5% of eligible women) were compared with all women who gave birth in the sampled weeks using the state’s population-based perinatal data collection. ’ HILTON lNTERNATlONAL HOTEL AOElfllOE 27-29 APAll 1999 ‘Let’s Get It Right Together’ Come and join Australia’s police, community leaders, policy maken,educators,health workers, correctional services officers and many others involved in develo ing effective drug strategies. Hosted by the South Australia olice the conference will provide contemporary strategies for law enforcement in partnership with the community. Leading speakers from Europe, US, Canada and Australasia will provide up-todate information on the latest research and what’s happening around the world in what is society’s most serious social problem. This conference will not be just another talkfest It will develo recommendations to be put before the Australian and Sout West Pacific Police Commissioners’ Conference for action. For further information about this conference please contact: Drugs Strategy Secretariat SA Police PO Box 1539 ADELAIDE SA 500 I Tel: (08) 8204 2820 Fax: (08) 8204 2634 E-mail: dap@camtech.netau Website: sapolice.sa.gov.au @) MOTOROLA I.,nlYII . I ,“lTlCI ITUDllS 1998 VOL. 22 NO. 7 AUSTRALIAN A N D N E W ZEALAND JOURNAL OF PUBLIC HEALTH Cook Letters to the Editor Women under 25 years old, single or born overseas of nonEnglish speaking background (NESB) were under represented in the survey.'The effect of under response by these groups of women on the prevalence of infertility is difficult to predict. Two-thirds of women who had been trying to get pregnant for more than 12 months had done so without treatment and 19% had conceived following treatment with fertility drugs. Assisted reproductive technologies have a high media profile, however, among this group of women who had recently given birth only a small percentage had conceived with the aid of medical intervention. Consistent with what has been reported elsewhere, the survey found that women giving birth after a period of infertility were likely to be olde$.l"and experienced a raised rate of caesarean section.'"," It is possible that pregnancies after infertility are perceived as particularly 'precious', perhaps lowering the threshold for Information on the number of women seeking medical help for infertility, possible future demand for services and use of medical intervention during labour have important implications for health-service planners and the health care budget. Further information is needed about the reasons why women do or do not seek treatment and the effectiveness of different infertility treatments. Infertility is an important public health issue that affects individuals, their families and society as a whole. It will continue to compete for health care resources in the coming years and deserves a more evidence-based approach to the provision of services. Retailer education and cigarette sales to teenagers Don Cook Health Promotion Officer, Central Coast Area Health Service, New South Wales References I. 2. 3. 4. 5. 6. 7. Webb S . Holman D. A survey of infertility, surgical sterility and associated reproductive disability in Perth, Western Australia. Aust JPublic Health 1992; 16(4): 376-8 1. Hirsch MB, Mosher WD. Characteristics of infertile women in the United States and their use of infertility services. F e d Steril 1987; 47(4): 618-25. Templeton A, Fraser C, Thompson B. The epidemiology of infertility in Aberdeen. BrMed J 1990; 301: 148-52. Gunnel1 DJ, Ewings P. Infertility prevalence, needs assessment and purchasing. JPublic Health Med 1994; 16(1): 29-35. Ghazi HA, Spielberger C, Kallen B. Delivery outcome after infertility - a registry study. Fertil Steril 1991; 55: 726-32. Williams MA, Goldman MB. Mittendorf R, Monson RR. Subfertility and the risk of low birth weight. F e d Steril 1991; 56(4): 668-71. Olsen J, Kuppers-Chinnow M, Spinelli A. Seeking medical help for subfecundity: A study based upon surveys in five European countries. F e d Steril 1996; 66(1): 95-100. Schmidt L, Munster K. Helm ?? Infertility and the seeking of infertility ueatment in a representative population. Br J Obstet Gynaecol 1995; 102: 978-84. Brown S, Lumley J. The 1993 Survey of Recent Mothers: Issues in survey design, analysis and influencing policy. Int J Qua1 Health Care 1997; 9 265-77. Venn A, Lumley J. Births after a period of infertility in Victorian women 1982-1990. Ausr NZ J Obsret Gvnaecol 1993; 33: 379-84. Li TC, MacLeod I. Singhal V, Duncan SLB. The obstetric and neonatal outcome of pregnancy in women with a previous history of infertility: a prospective study. Br J Obstet Gynaecol 1991; 98: 1087-92. Tuck SM. Yudkin PL, Turnbull AC. Pregnancy outcome in elderly primigravidae with and without a history of infertility. Br J Obstet Gvnaecol 1988; 95: 230-7. Does retailer education about public health legislation reduce smoking among high school students?l The answer is no. Does enforcement of the same legislation reduce smoking rates? The answer is probably yes.2 With so many retailers selling cigarettes, a product more readily available than milk3 (there are more than 450 outlets on the Central Coast), to have an effect a low selling rate obviously needs to be achieved so that it will be hard for teenagers to find a retail outlet willing to sell to them. After an intensive retailer education campaign lasting two years, our compliance survey (1994) still revealed an illegal selling rate close to 31%. What reduced this was a series of wellpublicised prosecutions, dropping that selling rate to 8% in 1996.4 Further enforcement and publicity has reduced this rate in 1997/ 98 to 5%.5 Because the study by Staff et al. did not measure the selling rate pre and post education, i.e. it did not measure retailer behavioul; we do not know if the retailer behaviour changed and this is surely the essential precursor to a change in the students' behaviour. For all we know, more retailers may have illegally sold cigarettes to the students following the information they got. Our work certainly shows retailers can be influenced by a form of education involving prosecution and information about the likelihood of being caught. We hope soon to be able to answer the question about selling rates and teenage smoking rates. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Australian and New Zealand Journal of Public Health Wiley

The prevalence of prior infertility in recent mothers

Download PDF
2 pages

Loading next page...
 
/lp/wiley/the-prevalence-of-prior-infertility-in-recent-mothers-sK9NpVg2yd

References (20)

Publisher
Wiley
Copyright
Copyright © 1998 Wiley Subscription Services, Inc., A Wiley Company
ISSN
1326-0200
eISSN
1753-6405
DOI
10.1111/j.1467-842X.1998.tb01507.x
Publisher site
See Article on Publisher Site

Abstract

Centre for the Study of Mothers’ and Children’s Health, La Trobe Universitx Victoria Accurate, population-based data on the prevalence of infertility is necessary to provide a basis from which to make informed policy, service planning and resource allocation decisions. However, very little is known about the underlying prevalence of infertility in the Australian community.’ Measuring the prevalence of infertility is complex and includes a number of difficulties, such as how to define and measure infertility and how to select an appropriate study population.The most commonly used definition of infertility is a failure to conceive after 12 months regular, unprotected intercourse. Some investigators have measured the proportion of women with infertility at a particular point in time, giving estimates of ‘current infertility’ of between 3.5%’ and 15.8%.2Other investigators have measured the proportion who have had a period of infertility some time during their reproductive life, giving estimates of 14.1 %3 to 26.4%.4 An alternative approach is to investigate the prevalence of prior infertility among a group of women who have recently given Although this approach excludes infertile women who have not become pregnant, it includes all women giving birth after a period of infertility and enables birth outcomes to be studied. Comparing women with and without prior infertility is of importance, because some studies (mainly using clinic-based samples) have suggested that maternal characteristics, and birth and perinatal outcomes may differ between these groups of women. Studies conducted overseas have indicated that less than half the women who reported difficulty conceiving sought medical treatment.’,’ The Survey of Recent Mothers was designed to investigate the experiences and views of Victorian women who had given birth during a two-week period in 1993. Infertility was one of a range of issues the survey investigated. Two questions in the survey asked about infertility. The first asked, “When you became pregnant with the baby you had in September, had you been trying to get pregnant for more than 12 months?’ Women who responded yes to this question were asked “If yes, did you have any treatment to help you get pregnant?’ The response rate was 62.5% (1,336/2,138). A detailed description of the study methodology is available e l ~ e w h e r e . ~ One hundred and twenty-eight (9.6%, 95% CI 8%-11.2%) women reported they had been trying to get pregnant for more than 12 months. Six (0.4%) women did not respond to this question. Forty (31.3%) of the 128 women who reported prior infertility had received treatment for infertility. Of these, 24 had taken fertility drugs to induce ovulation (one received treatment for endometriosis, in addition to ovulation induction), six had conceived using assisted reproductive technologies (ART), five had treatment for endometriosis, four did not specify what type of treatment they had received and one woman conceived after surgery. Three women (2.3%) did not indicate whether they had had treatment. Twenty-five per cent of women with prior infertility were 35 years (of age) or older at the time of the birth, compared with 10.8% of women not experiencing a period of infertility prior to the birth (OR 2.74, 95% CI 1.7-4.3). Women with prior infertility were more likely to give birth by caesarean section (OR 1.98,95% CI 1.3-3.0). They were not significantly more likely to have had their labour induced or augmented, nor were they significantly more likely to give birth to a preterm (<37 weeks gestation) or low birth weight infant ( ~ 2 , 5 0 0 grams). Just under 10% of women in this population-based sample had experienced a period of infertility prior to conception. Other studies have reported the prevalence of prior infertility among women who have recently given birth as 7.8%5 and 17.8%.6 The finding adds to a small body of population-based data on the prevalence of infertility in Australia. The characteristics of respondents to our survey (62.5% of eligible women) were compared with all women who gave birth in the sampled weeks using the state’s population-based perinatal data collection. ’ HILTON lNTERNATlONAL HOTEL AOElfllOE 27-29 APAll 1999 ‘Let’s Get It Right Together’ Come and join Australia’s police, community leaders, policy maken,educators,health workers, correctional services officers and many others involved in develo ing effective drug strategies. Hosted by the South Australia olice the conference will provide contemporary strategies for law enforcement in partnership with the community. Leading speakers from Europe, US, Canada and Australasia will provide up-todate information on the latest research and what’s happening around the world in what is society’s most serious social problem. This conference will not be just another talkfest It will develo recommendations to be put before the Australian and Sout West Pacific Police Commissioners’ Conference for action. For further information about this conference please contact: Drugs Strategy Secretariat SA Police PO Box 1539 ADELAIDE SA 500 I Tel: (08) 8204 2820 Fax: (08) 8204 2634 E-mail: dap@camtech.netau Website: sapolice.sa.gov.au @) MOTOROLA I.,nlYII . I ,“lTlCI ITUDllS 1998 VOL. 22 NO. 7 AUSTRALIAN A N D N E W ZEALAND JOURNAL OF PUBLIC HEALTH Cook Letters to the Editor Women under 25 years old, single or born overseas of nonEnglish speaking background (NESB) were under represented in the survey.'The effect of under response by these groups of women on the prevalence of infertility is difficult to predict. Two-thirds of women who had been trying to get pregnant for more than 12 months had done so without treatment and 19% had conceived following treatment with fertility drugs. Assisted reproductive technologies have a high media profile, however, among this group of women who had recently given birth only a small percentage had conceived with the aid of medical intervention. Consistent with what has been reported elsewhere, the survey found that women giving birth after a period of infertility were likely to be olde$.l"and experienced a raised rate of caesarean section.'"," It is possible that pregnancies after infertility are perceived as particularly 'precious', perhaps lowering the threshold for Information on the number of women seeking medical help for infertility, possible future demand for services and use of medical intervention during labour have important implications for health-service planners and the health care budget. Further information is needed about the reasons why women do or do not seek treatment and the effectiveness of different infertility treatments. Infertility is an important public health issue that affects individuals, their families and society as a whole. It will continue to compete for health care resources in the coming years and deserves a more evidence-based approach to the provision of services. Retailer education and cigarette sales to teenagers Don Cook Health Promotion Officer, Central Coast Area Health Service, New South Wales References I. 2. 3. 4. 5. 6. 7. Webb S . Holman D. A survey of infertility, surgical sterility and associated reproductive disability in Perth, Western Australia. Aust JPublic Health 1992; 16(4): 376-8 1. Hirsch MB, Mosher WD. Characteristics of infertile women in the United States and their use of infertility services. F e d Steril 1987; 47(4): 618-25. Templeton A, Fraser C, Thompson B. The epidemiology of infertility in Aberdeen. BrMed J 1990; 301: 148-52. Gunnel1 DJ, Ewings P. Infertility prevalence, needs assessment and purchasing. JPublic Health Med 1994; 16(1): 29-35. Ghazi HA, Spielberger C, Kallen B. Delivery outcome after infertility - a registry study. Fertil Steril 1991; 55: 726-32. Williams MA, Goldman MB. Mittendorf R, Monson RR. Subfertility and the risk of low birth weight. F e d Steril 1991; 56(4): 668-71. Olsen J, Kuppers-Chinnow M, Spinelli A. Seeking medical help for subfecundity: A study based upon surveys in five European countries. F e d Steril 1996; 66(1): 95-100. Schmidt L, Munster K. Helm ?? Infertility and the seeking of infertility ueatment in a representative population. Br J Obstet Gynaecol 1995; 102: 978-84. Brown S, Lumley J. The 1993 Survey of Recent Mothers: Issues in survey design, analysis and influencing policy. Int J Qua1 Health Care 1997; 9 265-77. Venn A, Lumley J. Births after a period of infertility in Victorian women 1982-1990. Ausr NZ J Obsret Gvnaecol 1993; 33: 379-84. Li TC, MacLeod I. Singhal V, Duncan SLB. The obstetric and neonatal outcome of pregnancy in women with a previous history of infertility: a prospective study. Br J Obstet Gynaecol 1991; 98: 1087-92. Tuck SM. Yudkin PL, Turnbull AC. Pregnancy outcome in elderly primigravidae with and without a history of infertility. Br J Obstet Gvnaecol 1988; 95: 230-7. Does retailer education about public health legislation reduce smoking among high school students?l The answer is no. Does enforcement of the same legislation reduce smoking rates? The answer is probably yes.2 With so many retailers selling cigarettes, a product more readily available than milk3 (there are more than 450 outlets on the Central Coast), to have an effect a low selling rate obviously needs to be achieved so that it will be hard for teenagers to find a retail outlet willing to sell to them. After an intensive retailer education campaign lasting two years, our compliance survey (1994) still revealed an illegal selling rate close to 31%. What reduced this was a series of wellpublicised prosecutions, dropping that selling rate to 8% in 1996.4 Further enforcement and publicity has reduced this rate in 1997/ 98 to 5%.5 Because the study by Staff et al. did not measure the selling rate pre and post education, i.e. it did not measure retailer behavioul; we do not know if the retailer behaviour changed and this is surely the essential precursor to a change in the students' behaviour. For all we know, more retailers may have illegally sold cigarettes to the students following the information they got. Our work certainly shows retailers can be influenced by a form of education involving prosecution and information about the likelihood of being caught. We hope soon to be able to answer the question about selling rates and teenage smoking rates.

Journal

Australian and New Zealand Journal of Public Health – Wiley

Published: Dec 1, 1998

There are no references for this article.