Decision-making about seeking medical advice in an internet sample of women trying to get pregnant.

INTRODUCTION In light of the near universal desire to become a parent one would expect most people to seek medical advice if they were experiencing difficulties conceiving. Yet less than 55% do so and we sought to understand more about this paradox by comparing the psychosocial profile and decision-making of women not yet engaged in the medical process to that of those who had consulted. METHODS A Fertility Decision-Making Questionnaire was designed and posted on a website dedicated to women trying to conceive. RESULTS A total of 426 women completed the questionnaire, 56% had not yet consulted a doctor about conceiving (non-consulter, NC). Women who had sought treatment had more positive treatment beliefs, and a greater willingness to know if a problem existed, than those who had not yet consulted. Almost 20% of NC women already met the medical definition of infertility and this subgroup had a greater fear of discovering a problem and of being labelled infertile than other women in the study. CONCLUSIONS Seeking medical advice for fertility problems is mainly associated with what women know or want to know about their fertility and their emotional reactions to that knowledge. Negative reactions can substantially delay seeking help in 20% of women.

[1]  F. V. van Balen,et al.  Choices and motivations of infertile couples. , 1997, Patient education and counseling.

[2]  R. Edelmann,et al.  Psychological aspects of in vitro fertilization: a gender comparison. , 1994, Journal of psychosomatic obstetrics and gynaecology.

[3]  A. Stewart,et al.  The MOS short-form general health survey. Reliability and validity in a patient population. , 1988, Medical care.

[4]  A. Greil,et al.  INFERTILITY: , 1988 .

[5]  C. Bachrach,et al.  Understanding U.S. fertility: continuity and change in the National Survey of Family Growth, 1988-1995. , 1996, Family planning perspectives.

[6]  Jochen P. Ziegelmann,et al.  Stage-specific adoption and maintenance of physical activity: testing a three-stage model , 2005 .

[7]  A. Neugut,et al.  Prostate Cancer Screening Behavior in Men from Seven Ethnic Groups: the Fear Factor , 2006, Cancer Epidemiology Biomarkers & Prevention.

[8]  Charles Abraham,et al.  The health belief model , 2005 .

[9]  R. Casper,et al.  Use of the internet by infertile couples. , 2000, Fertility and sterility.

[10]  I. Ajzen.  The theory of planned behavior , 1991 .

[11]  J. Boivin,et al.  International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. , 2007, Human reproduction.

[12]  J. Hendriks,et al.  Current Internet use and preferences of IVF and ICSI patients. , 2003, Human reproduction.

[13]  Sarah Bauerle Bass,et al.  How will Internet Use Affect the Patient? A Review of Computer Network and Closed Internet-based System Studies and the Implications in Understanding How the Use of the Internet Affects Patient Populations. , 2003 .

[14]  C. Newton,et al.  The Fertility Problem Inventory: measuring perceived infertility-related stress. , 1999, Fertility and sterility.

[15]  C. Lampic,et al.  Fertility awareness, intentions concerning childbearing, and attitudes towards parenthood among female and male academics. , 2006, Human reproduction.

[16]  J. Boivin,et al.  Sexual and emotional adjustment of couples undergoing infertility investigation and the effectiveness of preparatory information , 1990 .

[17]  K. Trinkaus,et al.  Psychological factors related to delay in consultation for cancer symptoms , 2005, Psycho-oncology.

[18]  C. Skinner,et al.  The health belief model. , 2008 .

[19]  S. Shiffman,et al.  Coping and Substance Use , 1985 .

[20]  John C. Norcross,et al.  In Search of How People Change: Applications to Addictive Behaviors , 1993 .

[21]  C. Carver,et al.  Optimism, coping, and health: assessment and implications of generalized outcome expectancies. , 2009, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[22]  D. Rubin,et al.  Contrasts and Effect Sizes in Behavioral Research: A Correlational Approach , 1999 .

[23]  D. Terry,et al.  Adjustment to a low-control situation: Reexamining the role of coping responses , 1998 .

[24]  Y. Kashima,et al.  Toward understanding women's decisions to continue or stop in vitro fertilization: The role of social, psychological, and background factors , 1988, Journal of in Vitro Fertilization and Embryo Transfer.

[25]  A. Ramirez,et al.  Understanding why women delay in seeking help for breast cancer symptoms. , 2005, Journal of psychosomatic research.

[26]  E. Freeman,et al.  Perceptions of infertility and treatment stress in females as compared with males entering in vitro fertilization treatment. , 1992, Fertility and sterility.

[27]  Judith Bernstein,et al.  Assessing the quality of infertility resources on the World Wide Web: tools to guide clients through the maze of fact and fiction. , 2002, Journal of midwifery & women's health.

[28]  A. Greil,et al.  Infertility: testing a helpseeking model. , 2006, Social science & medicine.

[29]  A. Neugut,et al.  Fear, anxiety, worry, and breast cancer screening behavior: a critical review. , 2004, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[30]  J. Verdurmen,et al.  Medical anxiety and the choice for treatment: The development of an instrument to measure fear of treatment , 1999 .

[31]  R. Nachtigall,et al.  'Born to be a mother': the cultural construction of risk in infertility treatment in the U.S. , 1994, Social science & medicine.

[32]  Jacob Cohen,et al.  A power primer. , 1992, Psychological bulletin.

[33]  A. Greil,et al.  Help‐seeking patterns among subfecund women , 2004 .

[34]  Sarah Bauerle Bass.  How will Internet Use Affect the Patient? A Review of Computer Network and Closed Internet-based System Studies and the Implications in Understanding How the Use of the Internet Affects Patient Populations , 2003, Journal of health psychology.