The challenge of providing infertility services to a low-income immigrant Latino population

Objective

To provide insight into the experience of low-income immigrant Latino couples seeking infertility treatment.

Design

Qualitative interview study.

Setting

Infertility clinic at a university-affiliated urban public teaching hospital.

Patient(s)

Infertile low-income immigrant Latino couples (105 women and 40 men).

Intervention(s)

In-depth, tape-recorded interviews.

Main Outcome Measure(s)

After transcription and translation, the interviews were coded and analyzed for thematic content.

Result(s)

Four major challenges to providing infertility services to this population were identified: [1] communication: language and cultural barriers resulted in patients having difficulty both in understanding diagnoses and treatments and in communicating their questions, concerns, and experiences to physicians; [2] continuity: because medical students and residents rotated frequently, patients usually saw a different physician at each visit; [3] bureaucracy: patients reported having difficulty with appointment scheduling, follow-up visits, and timed laboratory procedures; and [4] accessibility: patients faced issues of limited availability and affordability of treatment.

Conclusion(s)

At a large, urban, university-affiliated infertility clinic, challenges related to communication, comprehension, continuity, bureaucracy, accessibility, availability, and affordability impeded the delivery of optimal infertility care to many low-income immigrant Latino patients. A greater availability of translators and both patient and physician cultural orientations to address these health care barriers is recommended.

Key Words: Infertility, health care disparities, Latinos, low-income