Quantitative and Qualitative Analysis of Complementary and Alternative Medicine Content on Fertility Clinic Websites in the United States

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Fertility and Sterility





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Background: The use and availability of complementary and alternative medicine (CAM) in fertility treatment has become more widespread in recent years, although additional research is needed to determine its effectiveness. Examples of CAM therapies include acupuncture, yoga, herbal supplementation, and homeopathy. Fertility clinic websites are an important resource used by patients to obtain information for the types of services available to them. Patient accessibility to online information is an essential part of recognizing health disparities in regards to accessing fertility services. Objective: The goal of this study is to assess the prevalence of content associated with CAM on SART-reporting fertility clinic websites in the US, and to determine the association of demographic and socioeconomic factors with the online information provided by these websites. Materials and Methods: Websites of clinics reporting data to the Society for Associated Reproductive Technology (SART) for 2017 were evaluated for information on CAM by two independent reviewers. Each clinic website was examined for content related to alternative therapies or complementary medicine, as defined by the American Society for Reproductive Medicine. This was correlated to publicly available US Census Bureau (2014-2018) data, using county as a geographic proxy, to estimate demographic variables within the population. Descriptive statistical analyses were performed using chi-square statistics. Results: 360 SART-reporting fertility clinics with accessible websites were identified. 29% of websites discussed CAM services, either offered through the clinic or through referral resources on the website. 76% of these websites included additional information related to the topic of CAM, ranging from the definition of acupuncture to an extensive discussion of current research on CAM therapies. 34% of websites specifically discussed acupuncture, followed by yoga and herbal supplementation. Compared to the lower three income quartiles, there was a significant positive association between CAM services offered on fertility clinic websites and the highest quartile of median household income (MHI) (p=0.01) and highest quartile of income per capita (IpC) (p=0.01). This trend was also noted for populations with a Bachelor’s degree or higher (p=0.01) and for households with a computer (p=0.02). Regional differences were also observed; race was found to be a significant factor (p=0.04) in relation to CAM offered on websites in the Western Region, but not for the entire US. Conclusion: Approximately one-third of SART-reporting fertility clinics offer CAM as adjuncts to fertility treatment on their websites. Some websites supported CAM therapies and encouraged patients to discuss ways of incorporating CAM into their fertility treatments with their providers, whereas others were firmly against it. Although many websites offer CAM in conjunction with fertility treatment, only some websites provide information and guidance to patients on safe and recommended usage of CAM. This may ultimately be a disservice to patients, who may turn to unreliable sources for additional information, and consequently compromise their own fertility treatment in the process. Our study also demonstrates the importance of bridging the information gap so that CAM services are accessible across income and education levels. Financial Support: None.


Obstetrics and Gynecology | Public Health