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Objective-To determine the prevalence of Complementary and Alternative Medicine (CAM) use among couples seeking fertility care and to identify the predictors of CAM use in this population. Design-Prospective cohort study Setting-Eight community and academic infertility practices Patients-428 couples presenting for an infertility evaluation Interventions-Interviews and questionnaires Main Outcome Measures-Prevalence of complementary and alternative medicine therapyResults-After 18 months of observation, 29% of the couples had utilized a CAM modality for treatment of infertility; 22% had tried acupuncture, 17% herbal therapy, 5% a form of body work, and 1% had utilized meditation. An annual household income ≥ $200,000 (OR 2.8, p=.04) relative to couples earning < $100,000, not achieving a pregnancy (OR 2.3, p=.01), and a positive attitude toward CAM use at baseline (p<.001) were independently associated with CAM use.Conclusions-A substantial minority of infertile couples utilize CAM treatments. CAM was chosen most commonly by wealthier couples, those not achieving a pregnancy, and those with a baseline belief in the effectiveness of CAM treatments.

IMPORTANCE Social and economic contexts shape children's short-and long-term health. Efforts to address contextual risk factors are increasingly incorporated into pediatric health care. OBJECTIVE To compare the effectiveness of 2 social risk-related interventions. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial included English-and/or Spanish-speaking caregiver-child dyads recruited from a pediatric urgent care clinic nested in a large,

Introduction Male factor infertility is a relatively common problem. This diagnosis may increase sexual, marital, and relationship strain in male partners of infertile couples. Aim To measure the personal, social, sexual, and marital impacts of a male factor infertility diagnosis among men in couples evaluated for infertility. Methods Cross-sectional analysis of 357 men in infertile couples from eight academic and community-based fertility clinics. Participants completed written surveys and face-to-face and telephone interviews at study enrollment. This interview queried each participant’s perception of their infertility etiology to determine the primary study exposure (i.e., male factor only, male and female factors, female factor only, unknown). Main Outcome Measures Personal Impact, Social Impact, Marital Impact, and Sexual Impact scales. Results Among the 357 men, no male factor was reported in 47%, isolated male factor was present in 12%, combined male and female factors were present in 16%, and unexplained infertility was present in 25% of couples. Male factor infertility was independently associated with worse Sexual (mean 39 vs. 30, standard deviation [SD] 2.7, P = 0.004) and Personal (mean 37 vs. 29, SD 3.8, P = 0.04) Impact scores relative to men in couples without male factor infertility. These differences remained statistically significant after controlling for male age, partner age, race, religion, educational level, employment status, prior pregnancy, duration of infertility, and prior paternity. Conclusions Male partners in couples who perceive isolated male factor infertility have a lower sexual and personal quality of life compared with male partners of couples without perceived male factor infertility. Social strain is highest among couples without a clear etiology for infertility. These findings highlight the clinically significant negative sexual, personal, and social strains of a perceived infertility diagnosis for men.