Infertility and Health-Related Quality of Life in United States Women Veterans

Abstract

Background: To assess associations between infertility and health-related quality of life and medical comorbidities in U.S. women Veterans. Materials and Methods: This cross-sectional observational study involved computer-assisted telephone interviews of Veterans Administration-enrolled women between ages 21 and 52 years. Patients were analyzed in two groups by self-reported history of infertility. Outcomes included health-related quality of life as measured by the short-form 12-item interview (SF-12) physical and mental component summary (PCS and MCS) scores, depression, post-traumatic stress disorder (PTSD), eating disorders, fibromyalgia, other chronic pain, cardiovascular disease risk factors, and cancer. Age-adjusted p-values and adjusted odds ratios (AORs) were calculated using individual multivariate regression models to control for significant confounding covariates. Results: Of the 996 women veterans included, 179 (18.0%) reported a history of infertility. Infertility was associated with worse perceived physical health as determined by the SF-12 PCS [beta coefficient (B) -3.23 (-5.18 to -1.28)] and fibromyalgia [AOR 1.97 (1.22 to 3.19)]. Infertility was also associated with higher rates of depression, other chronic pain, and cancer, which remained significant after adjusting for age (p = 0.021, p = 0.016, and p = 0.045, respectively); however, no association for all was seen after adjustment for other significant covariates. There was no difference in Veterans' mental health using the SF-12 MCS, nor differences seen in PTSD or eating disorder rates, or in cardiovascular risk factors. Conclusions: This novel investigation in U.S. women Veterans found worse physical health-related quality of life and increased rates of fibromyalgia among women reporting a history of infertility, adding to the growing literature on infertility as a marker for overall poorer health.