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ity and on the receipt of infertility services from the 1995 National Survey of Family Growth (NSFG) allow us to determine whether and how these phenomena have changed since they were last measured in 1988. Such trend analysis has implications for projecting future health care costs, particularly in an arena of changing insurance coverage and potential health care reform. It may also be relevant in assessing whether access to services is equal among infertile subgroups. For example, nationally representative data have indicated that infertile couples are not disproportionately white or of high socioeconomic status, but infertile couples who have sought out medical help have been consistently more likely to be white, collegeeducated and affluent.4 Describing the currently infertile population is a crucial first step toward projecting future demand for services. That demand hinges on at least two components: estimates of the number of individuals likely to have fertility problems, and estimates of the number of individuals likely to pursue medical help for infertility.5 Clearly, many factors affect the validity of assumptions used to estimate future infertility rates and service utilizaAnjani Chandra is a demographer in the Reproductive Statistics Branch, Division of Vital Statistics, National Center for Health Statistics, Hyattsville, MD. Elizabeth Hervey Stephen is an associate professor of demography, Georgetown University, Washington, DC. An earlier version of this article was presented at the annual meeting of the Population Association of America, Mar. 29, 1997, in Washington, DC. The series of surveys on which this article is based, the National Survey of Family Growth, was jointly planned and funded primarily by the National Center for Health Statistics, the National Institute for Child Health and Human Development and the Office of Population Affairs, with additional support from the Administration for Children and Families. Impaired Fecundity in the United States: 1982–1995