When do involuntarily infertile couples choose to seek medical help?

Objective: To estimate the probability of medical consultation for infertility during the course of a pregnancy attempt and to study its determinants. Design: Pregnancy-based retrospective telephone survey analyzed with a discrete time Cox model. Setting: Two rural counties in Brittany and Normandy, France. Patient(s): A random sample of 901 women from the general population aged 18-60 years reporting 1,460 pregnancy attempts resulting in a live birth between 1985 and 2000 (participation rate, 73%). Intervention(s): None. Main Outcome Measure(s): Probability of medical consultation for involuntary infertility cumulated over time. Result(s): The cumulative probability of medical consultation for involuntary infertility among nulligravid women was 45% after 12 months of involuntary infertility and 75% after 24 months. The probability of medical consultation at any time was half that for parous women (odds ratio 0.4, 95% confidence interval 0.2-0.6). More highly educated women were more likely to have sought medical help for infertility. Only 45% of women who had sought medical advice received infertility treatment. Conclusion(s): Our survival approach provides a description of infertility service use during the course of a pregnancy attempt, and confirms that parity and educational level are strong predictors of medical help-seeking behaviors.