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

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. (Fertil Steril (R) 2009;92:116-23. (C)2009 by American Society for Reproductive Medicine.)