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

Fertil Steril. 2009 Jul;92(1):116-23. doi: 10.1016/j.fertnstert.2008.05.037. Epub 2008 Aug 16.


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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Emigrants and Immigrants
  • Female
  • Health Services Accessibility*
  • Hispanic or Latino
  • Humans
  • Infertility, Female / therapy
  • Infertility, Male / therapy
  • Interviews as Topic
  • Language
  • Male
  • Middle Aged
  • Poverty
  • Reproductive Techniques, Assisted*
  • San Francisco
  • Young Adult