Inequity in Fertility Treatment for Patients that Speak a Language Other than English: A Retrospective Cohort Study.

IF 3.2 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Racial and Ethnic Health Disparities Pub Date : 2024-10-25 DOI:10.1007/s40615-024-02188-6
Anwyn Pyle, Wan Tinn Teh, Michelle L Giles
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Abstract

Objective: To assess fertility treatment outcomes according to primary language spoken in patients undergoing fertility treatment in an Australian setting.

Methods: This retrospective cohort study examined female patients who received fertility treatment through a public hospital fertility service between September 2020 and May 2023. The primary outcome was clinical pregnancy rate following embryo transfer for patients who spoke English and patients who primarily spoke a language other than English. Poisson regression was used to estimate the association between language spoken and clinical pregnancy rate. Secondary outcomes included rate of other pregnancy outcomes following embryo transfer, number of fertility treatments performed, embryo quality, IVF cancellation rate, discontinuation rate, and time from first fertility appointment to treatment commencement.

Results: Of the 916 patients who accessed fertility treatment during the study period, 112 patients (12.23%) primarily spoke a language other than English. There were no significant differences in clinical pregnancy rate following embryo transfer (IRR 0.92, 95% CI 0.60-1.36), or rates of biochemical pregnancy, miscarriage, or negative pregnancy. However, patients who spoke a language other than English received significantly fewer IVF cycles (1.29 ± 0.61 vs 1.63 ± 1.16 cycles, p = 0.006), greater all-cause IVF cancellation rate (41.33% vs 28.33%, p = 0.048), and longer median time from first appointment to first treatment of any type (341 vs 234.5 days, p < 0.001).

Conclusion: Inequity in all-cause IVF cancellation rate, mean number of IVF cycles, and duration from first fertility appointment to treatment commencement were observed for patients who spoke a language other than English.

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讲英语以外语言的患者在生育治疗中的不平等:回顾性队列研究
目的根据在澳大利亚接受生育治疗的患者所使用的主要语言,评估生育治疗效果:这项回顾性队列研究对 2020 年 9 月至 2023 年 5 月期间通过公立医院不孕不育服务接受不孕不育治疗的女性患者进行了调查。主要结果是会讲英语的患者和主要讲英语以外语言的患者胚胎移植后的临床妊娠率。泊松回归用于估计所讲语言与临床妊娠率之间的关系。次要结果包括胚胎移植后其他妊娠结果的发生率、进行生育治疗的次数、胚胎质量、试管婴儿取消率、中止率以及从首次生育预约到开始治疗的时间:在研究期间接受生育治疗的 916 名患者中,有 112 名患者(12.23%)主要讲英语以外的语言。胚胎移植后的临床妊娠率(IRR 0.92,95% CI 0.60-1.36)、生化妊娠率、流产率或阴性妊娠率均无明显差异。在所有原因的试管婴儿取消率、试管婴儿周期的平均次数以及从首次生育预约到开始治疗的持续时间方面,观察到讲英语以外语言的患者之间存在不平等。
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来源期刊
Journal of Racial and Ethnic Health Disparities
Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
7.30
自引率
5.10%
发文量
263
期刊介绍: Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.
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