P-719 Self-declared infertility and child desire among women of reproductive age in the National Survey of Demography and Health, Brazil
Authors: Garcia S , Koyama M 
Published: August 2021

Abstract

Study question
This article aims to characterize from a socio-demographic point of view, women of reproductive age who wish to have children, declared themselves infertile, and their search for treatments and outcomes.

Summary answer
It is essential to develop specific population surveys on infertility in Brazil to identify its magnitude and main economic and social components.

What is known already
Commonly neglected in developing countries where public policy is incipient, infertility brings social, economic and psychological consequences to couples. It is considered as a serious public health problem whose impact varies among different populations and acquires relevance for specific communities. In Brazil, there are no clinical or demographic data that point us to the magnitude of the problem, its social characteristics and impact. Taking into account the postponement of motherhood for after 30 years, there will probably be an increase in the number of women and couples who may resort to infertility treatments to fulfil the desire for procreation.

Study design, size, duration
The National Survey of Demography and Health of Women and Children (PNDS) is a cross-sectional study and a household complex probabilistic sampling. The sampling units were selected according to a stratified model of simple random conglomerates in two stages: lottery draw and household draw. The last survey was conducted between June 2006 and May 2007 in 14,617 households. In the selected households, interviews were conducted with 15,575 women of reproductive age.

Participants/materials, setting, methods
The participants consisted of 15.575 women between 15 and 49 years, representative of the five Brazilian macro-regions. The information was obtained through questionnaires, applied in person, raising information on fertility, fecundity, contraception, use of health services and socioeconomic profile. The interviewer’s team was formed by approximately 100 people and 27 supervisors, all-female, divided into nine regional teams. The system used for data entry was the Census and Survey Processing System - CSPro.

Main results and the role of chance
The survey results indicate that of women who wish to have children, 9.2% declared themselves infertile; 50,8% of them sought health services for treatment; non-black women had higher percentages of demand compared to black women (62.4% versus 41.3%). Also, there were higher percentages of seeking help from women belonging to classes A (61.2%), B (83.3%) and C (60.9%) compared to those belonging to classes D (30.4%) and E (7.8%) On the other side, almost half of women did not seek help to get pregnant (49,1%); this percentage is higher among black women (58%). Moreover, women in classes D and E had the highest percentages of non-demand, 69.6% and 92.2%, respectively. The reasons cited for those who do not seek help, are “I think there is no solution” (54,7%); “I don’t think I can get help” (17.3%), “financial reasons” (26.8%) or “I don’t know where to get it” (1,2%). Among those who sought help, 48,5% are under treatment, 24,4 % said there is no solution; 15,8% are waiting for service and 11,3% have no money for treatment. Significance limit was established for values of p &lt; 0.05. The analysis was performed in the programs Stata v.9 and/or SPSS v.14.

Limitations, reasons for caution
The limitations of the study are recognized. Firstly, opinions are restricted to the moment of the interview and, thus, the desire for children may change over time. Secondly, the statement of infertility is based on self-declaration, not on clinical diagnosis.

Wider implications of the findings
This is the first study based on PNDS 2006 data on infertility and demand for treatments in Brazil. It can contribute to providing insights, raising new questions and discovering relevant categories and dimensions of analysis to be taken into account in future studies and surveys.

Trial registration number
not applicable