Perceptions of women's infertility: what do physicians see?

OBJECTIVE To assess physicians' awareness of the infertility risk associated with race, age, and education, and to elicit their clinical management recommendations for a hypothetical patient. DESIGN Cross-sectional survey. SETTING Surveys were mailed to 1,000 randomly selected primary care physicians in the state of Michigan. PATIENT(S) None. INTERVENTIONS(S) None. MAIN OUTCOME MEASURE(S) Self-reported questionnaire asking the relative prevalence of infertility among women based on race, education, and age. Physicians were also asked what interventions they would recommend for one of four hypothetical female infertility patients who were either European American or African American and either a working professional or receiving Medicaid. RESULT(S) Although most physicians did not correctly identify the associations between age, race, and socioeconomic status and women's infertility, their suggested clinical interventions did not vary based on a hypothetical patient's race or socioeconomic status. Female physicians, obstetrician/gynecologists, and physicians with more infertility experience or who had seen more infertile patients recommended more components of a model standard of care. CONCLUSION(S) A questionnaire using a hypothetical patient model suggests that primary care physicians may not be sufficiently aware of the infertility risk of African American women and women with lower socioeconomic status to ensure that women in need of services are identified.