Impaired Fecundity in the United States: 1982-1995

Citation: Chandra, A., Stephen, E. H. Impaired Fecundity in the United States: 1982-1995.
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Tagged: uw-madison (RSS), wisconsin (RSS), sociology (RSS), demography (RSS), prelim (RSS), qual (RSS), WisconsinDemographyPrelimAugust2009 (RSS)

Summary

Using data from the 1982, 1988, and 1995 rounds of the National Survey of Family Growth (NSFG), the authors examine trends in both the proportions and the numbers of women with impaired fecundity and of those who received infertility services. In all three waves, blacks were oversampled and Hispanic women were oversampled in 1995. The total numbers of observations in the data in each wave were 7,969 on 1982; 8,450 in 1988; and 10,847 in 1995. Multiple logistic regressions were carried out to estimate the effects of demographic characteristics on the likelihood of currently having impaired fecundity and of ever having received medical help for infertility. Women were classified into one of these 3 subgroups: nonsurgically sterile (impossible to conceive or deliver a baby); subfecund (physically difficult to conceive or should not conceive for medical reasons); or long interval without a conception (has not conceived in the 36 months despite being continuously in a union and having unprotected intercourse in each month). The other dependent variable use din this analysis was whether the woman had sought medical help to achieve pregnancy or avoid miscarriage. Results of the analysis show that the proportion of U.S. women aged 15-44 who reported some form of fecundity impairment rose from 8% in 1982 and 1988 to 10% in 1995, an increase in absolute numbers from 4.6 million to 6.2 million women. The only group of impairment that changed over this period is that of subfecund women. A higher percentage of nulliparous women with impaired fecundity were in the oldest reproductive age-group in 1995. Between 1982 and 1995 the percentage of women with impaired fecundity who had ever had PID fell from 23% to 14%. The percentage of women with impaired fecundity that want to have more children has increased from 60% to 71% in 1995. In 1995, blacks were marginally more likely to have impaired fecundity. Women with impaired fecundity were on average older, married, wanted a baby, have adopted a child, and had PID. Although the proportion of fecundity-impaired women who had ever sought medical help did not change between 1988 and 1995 (44%), the absolute numbers of such women grew by nearly 30%, from 2.1 million to 2.7 million. Women who had ever sought help for fertility problems were married, older, well-educated, white and had a higher income than those who had not, and were more likely to be married. Women who recently received services were more likely to be younger, nulliparous, want a child at the interview, and somewhat more likely to have a history of PID (at 15% alpha level). The pursuit of medical help increased substantially among both the youngest (ages 15-24) and the oldest women (ages 35-44), so that the effect of age on seeking medical help declined over time. The dramatic increase in the numbers of U.S. women with impaired fecundity occurred because the large baby boom cohort, many of whom delayed childbearing, had reached their later and less fecund reproductive years. This increase in both rates and numbers occurred across almost all age, parity, marital status, education, income, and race and ethnicity subgroups.