Risk factors for resignation from work after starting infertility treatment among Japanese women: Japan-Female Employment and Mental health in Assisted reproductive technology (J-FEMA) study

Abstract

ObjectiveTo elucidate the risk factors associated with resignation from work of Japanese women undergoing infertility treatment.MethodsA total of 1727 female patients who attended a private fertility clinic in Japan participated in the Japan-Female Employment and Mental health in Assisted reproductive technology study. Questions related to demographic, clinical and socioeconomic characteristics were employed in the questionnaire. Out of the 1727 patients, 1075 patients who were working at the time of initiating infertility treatment and felt infertility treatment incompatible with work were included in the analysis. Risk factors for resignation were assessed by using multivariable logistic regression models.ResultsAmong 1075 working women who started infertility treatment, 179 (16.7%) subsequently resigned. Multivariable-adjusted ORs for resignation in those with lower educational background and infertility for ≥2 years were 1.58 (95% CI: 1.07 to 2.34) and 1.82 (95% CI: 1.15 to 2.89), respectively. The OR for resignation in non-permanent workers undergoing infertility treatment was 2.65 (95% CI: 1.61 to 4.37). While experiencing harassment in the workplace approached significance, lack of support from the company was significantly associated with resignation after starting infertility treatment, with ORs of 1.71 (95% CI: 0.98 to 2.99) and 1.91 (95% CI: 1.28 to 2.86), respectively.ConclusionOne-sixth of women resigned after starting infertility treatments. It was found that factors related to education, infertility duration and work environment were significantly associated with resignation. Reducing the physical and psychological burden endured by women, for example, by increasing employer-provided support, is vitally important in balancing infertility treatment with maintenance of work life.

Out-of-pocket payment and patients’ treatment choice for assisted reproductive technology by household income: a conjoint analysis using an online social research panel in Japan

“…To recruit eligible samples efficiently, the market research company invited a large sample to the pre-screening, accepted responses in order of arrival and invited randomly selected participants to the survey. However, the sociodemographic distribution of our participants was similar to that of previous clinical settings in Japan [30], and patients with fertility problems tend to have higher education levels. Thus, our data should not be heavily influenced by potential selection bias.…”

“…Another important finding of this study relates to women engaged in paid work for 40 h or more per week, who were more likely to choose treatment if they could visit outpatient clinics at night or on weekends. Aligned with rises in parental age and women’s labour force participation [ 2 ], 60% of women receiving fertility care have concerns about missing work [ 29 ], and about 17% of women in Japan resign from their jobs after starting fertility treatment [ 30 ]. We found that medical institutions offering consultation during nights and weekends were preferred by participants working outside the home.…”

“…We found that medical institutions offering consultation during nights and weekends were preferred by participants working outside the home. Since ART procedures require frequent and sometimes unpredictable visits based on the menstrual cycle [ 30 ], providing flexible clinic hours and a supportive work environment would help employees balance their fertility treatments with their work schedules [ 31 ].…”

Sho-Based Kampo Medicine Combined With Assisted Reproductive Technology Is Effective for Refractory Infertility and Early Recurrent Miscarriage: A Case Report

“…It is not clear why the Sho pattern in our patient changed 6 months after starting treatment with KBG. Imai et al ( 19 ) reported that lower educational background, longer duration of infertility (>2 years), being non-permanent worker, harassment experience in the workplace, and lack of support within one's company were identified as risk factors for stress after initiating infertility treatment. It is possible that infertility itself and infertility treatment are associated with increased distress.…”

Occupational stress and related factors among childless working women in their 20s–40s: A pregnancy perspective

“…A 2018 survey found that 7.4% of women who underwent infertility treatment experienced harassment because of it 11) . Of the women who were working at the start of infertility treatment, 16.7-50.1%, or one in 2-6, had left the workforce 10,12,13) , with the lack of workplace support being one of the risk factors for leaving 10,13) . Thus, women are subjected to various occupational stressors owing to pregnancy and childbirth.…”