Reproductive healthcare use before and after infertility diagnosis: a population-based study in South Korea.

OBJECTIVES

This study examines heterogeneity in women's use of reproductive healthcare services before and after receiving an infertility diagnosis and its association with pregnancy identified without recorded loss within one year following the first infertility diagnosis. Reproductive healthcare use was operationalised as care-seeking history, utilisation intensity and subsequent engagement with assisted reproductive technology (ART) and financial support.

DESIGN

Population-based retrospective cohort study. Multivariate logistic regression analyses were performed.

SETTING

Korean National Health Insurance Service nationwide claims database.

PARTICIPANTS

Women aged 20-49 years with a first recorded infertility diagnosis in 2019-2020 (n=151 570).

OUTCOME MEASURES: Pregnancy identified without recorded loss within 1 year after infertility diagnosis.

RESULTS

Differences between women who did and did not have a pregnancy identified without recorded loss were more pronounced in pregnancy-related diagnostic codes recorded prior to infertility diagnosis than in classical genitourinary disorders. ART use (OR: 1.66; 95% CI 1.60 to 1.72) and financial support (OR: 1.60; 95% CI 1.54 to 1.67) were positively associated with pregnancy; however, these associations were modest relative to age and socioeconomic gradients. Greater postdiagnostic healthcare utilisation was associated with lower odds of pregnancy identification.

CONCLUSIONS

Women diagnosed with infertility exhibit heterogeneous patterns of prediagnostic and postdiagnostic healthcare engagement. Our findings suggest that infertility diagnosis is situated within women's broader reproductive healthcare engagement, highlighting the need for a patient-centred monitoring and evaluation system for women's health.