Female Infertility in the U.S. and India: An Analysis of Treatment Barriers and Coping Strategies

This research studies barriers to accessing fertility treatment in the United States (U.S.) and India, as well as the coping strategies infertile women use. Barriers include reproductive health knowledge, cost, and politics, while coping is affected by cultural stigma, family, and religion. These two countries were chosen for their different cultural contexts, healthcare systems, and political infrastructure. Ten fertility specialists across both countries were interviewed as expert informants. Reproductive health knowledge was the most important barrier to accessing care in both countries, with similar gaps in understanding when and what type of care to utilize, though social media can educate and empower patients. Cost and politics played a greater role in the U.S. because of access and coverage inequalities by state. For coping, cultural stigma was cited as the most important factor in each country despite the difference in sources of stigma, namely the historical racial differences in who has been able to utilize fertility treatment in the U.S. and the closely intertwined nature of culture and family in India. In both countries, the link between coping and family remains unclear because support is highly individualized. Religion can be a great source of support for many patients, especially in India. Recommendations include providers, patients, and governmental organizations continuing to raise awareness for infertility using media, particularly around infertility diagnosis and treatment and better, age-appropriate reproductive health education. Further medicalization of infertility can ease the burden on individuals and ultimately achieve universal health coverage.