Associations between social and economic determinants of health and receiving infertility care among female Veterans: across-sectional study

Zoe H. Pleasure; Michelle A. Mengeling; Ginny L. Ryan; A. M. Racila; Samantha K. Benson; Siobhan S. Mahorter; Anne G. Sadler; Judy E. Stern; Mark Vander Weg; Lisa S. Callegari

doi:10.1016/j.xfre.2026.05.003

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Associations between social and economic determinants of health and receiving infertility care among female Veterans: across-sectional study

Journal article

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Associations between social and economic determinants of health and receiving infertility care among female Veterans: across-sectional study

Zoe H. Pleasure, Michelle A. Mengeling, Ginny L. Ryan, A. M. Racila, Samantha K. Benson, Siobhan S. Mahorter, Anne G. Sadler, Judy E. Stern, Mark Vander Weg and Lisa S. Callegari

F&S Reports (Online), Vol.7(4), pp.280-289

08/01/2026

DOI: 10.1016/j.xfre.2026.05.003

PMCID: PMC13494616

PMID: 42630523

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https://doi.org/10.1016/j.xfre.2026.05.003View

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Abstract

Objective: To examine the associations between social and economic determinants of health with receipt of infertility diagnoses and care among Veterans. In the non-Veteran population, socially and economically marginalized individuals are less likely to receive infertility care. Little is known about these associations in the population of United States military Veterans, who may have unique fertility care needs and healthcare access experiences. Design: We analyzed cross-sectional survey data collected from the Impact of Sexual Assault and Combat-Related Trauma on Fertility in Veterans study conducted from 2016 to 2020. Subjects: Our analytic sample includes the subset of Veterans aged 20-45 years who were assigned female sex at birth and experienced infertility, defined as a self-reported history of unprotected sex for 12 or more months without pregnancy. Exposure: Variables of interest included social and economic determinants, including income, Veterans Health Administration (VA) benefits and insurance status, marital status, race and ethnicity, and sexual orientation. Main Outcome Measures: Outcomes included self-reported receipt of an infertility diagnosis and fertility treatment. Associations between social and economic determinants and the outcomes were evaluated using multivariable logistic regression. Age and lifetime diagnoses of mental health conditions were included as potential confounders of these associations.

Reproductive Biology

Life Sciences & Biomedicine

Obstetrics & Gynecology

Science & Technology

Details

Title: Subtitle: Associations between social and economic determinants of health and receiving infertility care among female Veterans: across-sectional study
Creators: Zoe H. Pleasure - University of Washington
Michelle A. Mengeling - University of Iowa
Ginny L. Ryan - University of Washington
A. M. Racila - University of Iowa
Samantha K. Benson - VA Puget Sound Health Care System
Siobhan S. Mahorter - VA Puget Sound Health Care System
Anne G. Sadler - University of Iowa
Judy E. Stern - Dartmouth College
Mark Vander Weg - Iowa City VA Hlth Care Syst, Ctr Access & Delivery Res & Evaluat CADRE, Iowa City, IA USA
Lisa S. Callegari - University of Washington
Resource Type: Journal article
Publication Details: F&S Reports (Online), Vol.7(4), pp.280-289
DOI: 10.1016/j.xfre.2026.05.003
PMID: 42630523
PMCID: PMC13494616
eISSN: 2666-3341
Publisher: Elsevier
Number of pages: 10
Language: English
Date published: 08/01/2026
Academic Unit: Psychiatry; Injury Prevention Research Center; General Internal Medicine; Community and Behavioral Health; Internal Medicine
Record Identifier: 9985222742802771

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