Frontiers in reproductive health · 2026
Prevalence and determinants of fertility care-seeking among women experiencing delayed conception in North India: a cross-sectional study.
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Gadapani Pathak Barsha, Mburu Gitau, Habib Ndema, Kabra Rita, Kiarie James, Chowdhury Ranadip, Dhabhai Neeta, Mazumder Sarmila
Аннотация
BACKGROUND: Infertility affects a substantial proportion of couples in low- and middle-income countries, yet access to fertility care remains limited. In India, research has primarily focused on psychosocial and biomedical aspects of infertility, with comparatively limited attention to care-seeking behaviours. Understanding the determinants of care-seeking is critical for promoting equitable access to infertility services.
METHODS: We conducted a cross-sectional study among 1,530 married women, aged 18-30 years, who intended to conceive and lived in low- to middle-socioeconomic urban neighbourhoods of Delhi. All participants had not conceived after 18 months of participation in a preconception randomized-control trial. Structured interviews captured information on sociodemographic characteristics, fertility intentions, psychosocial experiences, and care-seeking actions. Care-seeking was categorized as formal (health system providers), informal (family or traditional healers), or mixed.
RESULTS: 69.9% of women sought some form of help for delayed conception and, among them 85.5% consulted both formal and informal sources. Logistic regressions identified predictors of care-seeking where longer duration of trying to conceive [adjusted odds ratio (aOR) 1.6 per year, 95% CI: 1.4-1.7], perceiving conception as taking too long (aOR 3.1, 95% CI: 2.1-4.5), feeling isolated (aOR 1.7, 95% CI: 1.2-2.4), emotional abuse from husbands (aOR 1.7, 95% CI: 1.2-2.4) or family members (aOR 1.6, 95% CI: 1.2-2.2), and heavy menstrual bleeding (aOR 1.5, 95% CI: 1.0-2.2) were associated with greater odds of care-seeking, while regular menstrual cycles were associated with lower odds (aOR 0.6, 95% CI: 0.4-0.9). The negative association of regular cycles with care-seeking was significantly modified by social isolation (interaction aOR 3.78, 95% CI: 1.20-11.89).
CONCLUSION: These findings underscore the importance of integrating psychosocial support and fertility education into accessible, affordable infertility services within the public health system.
METHODS: We conducted a cross-sectional study among 1,530 married women, aged 18-30 years, who intended to conceive and lived in low- to middle-socioeconomic urban neighbourhoods of Delhi. All participants had not conceived after 18 months of participation in a preconception randomized-control trial. Structured interviews captured information on sociodemographic characteristics, fertility intentions, psychosocial experiences, and care-seeking actions. Care-seeking was categorized as formal (health system providers), informal (family or traditional healers), or mixed.
RESULTS: 69.9% of women sought some form of help for delayed conception and, among them 85.5% consulted both formal and informal sources. Logistic regressions identified predictors of care-seeking where longer duration of trying to conceive [adjusted odds ratio (aOR) 1.6 per year, 95% CI: 1.4-1.7], perceiving conception as taking too long (aOR 3.1, 95% CI: 2.1-4.5), feeling isolated (aOR 1.7, 95% CI: 1.2-2.4), emotional abuse from husbands (aOR 1.7, 95% CI: 1.2-2.4) or family members (aOR 1.6, 95% CI: 1.2-2.2), and heavy menstrual bleeding (aOR 1.5, 95% CI: 1.0-2.2) were associated with greater odds of care-seeking, while regular menstrual cycles were associated with lower odds (aOR 0.6, 95% CI: 0.4-0.9). The negative association of regular cycles with care-seeking was significantly modified by social isolation (interaction aOR 3.78, 95% CI: 1.20-11.89).
CONCLUSION: These findings underscore the importance of integrating psychosocial support and fertility education into accessible, affordable infertility services within the public health system.