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Fecundity and Infertility Among Women with Disabilities in the United States.

BACKGROUND
Knowledge of fecundity and infertility in women with a disability (WWD) is limited. This study aims to compare the fecundity and infertility experiences of women with a self-identified disability, in domains of sensory (hearing and vision loss), cognitive (difficulty concentrating, remembering, and making decisions), and physical (difficulty walking or climbing stairs) disabilities, with those without a self-identified disability.


MATERIALS AND METHODS
Cross-sectional survey data from the National Survey of Family Growth (NSFG), 2011-2015, were analyzed. A final analytic sample of 383 women from the NSFG, aged 18-44 years, was included to study the fecundity rates of WWD and women without a disability, using the current duration approach.


RESULTS
Fecundity hazard ratios (FHRs) and the proportion of women experiencing infertility after 12 months of actively attempting pregnancy were reported for the comparison group and by each disability type. Women with a self-identified cognitive disability experienced significant decreases in fecundity (FHR = 0.56; 95% confidence interval [CI]: 0.30-0.88) when adjusting for age, education level, parity, living in a metropolitan area, and infertility services. Furthermore, the estimated proportion of infertile women without a disability was 0.38 (95% CI: 0.23-0.62) versus 0.51 (95% CI: 0.34-0.72) for women with a self-identified cognitive disability.


CONCLUSIONS
Women with a self-identified cognitive disability experienced significant decreases in fecundity.