Journal Article

Validity of Self-reported Causes of Subfertility

Evelien J. de Boer, Isolde den Tonkelaar, Curt W. Burger and Flora E. van Leeuwen

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 161, issue 10, pages 978-986
Published in print May 2005 | ISSN: 0002-9262
Published online May 2005 | e-ISSN: 1476-6256 | DOI:
Validity of Self-reported Causes of Subfertility

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The authors assessed the accuracy of cause(s) of subfertility as reported by women in a self-administered questionnaire in comparison with medical record information, in a nationwide cohort study of women receiving in vitro fertilization treatment in the Netherlands (n = 9,164) between 1983 and 1995. Validity was expressed as sensitivity and specificity, and reliability was expressed by the kappa statistic and overall agreement between self-reports and medical records for various subfertility categories. The sensitivity for subfertility attributed to tubal, male, hormonal, cervical, uterine, and idiopathic factors and for endometriosis was 84%, 78%, 65%, 40%, 46%, 59%, and 83%, respectively. The corresponding kappas were 0.79, 0.71, 0.38, 0.34, 0.13, 0.50, and 0.52, respectively. For 54% of all women who reported two or more causes of subfertility, the medical record revealed only one major factor. Conversely, for 43% of all women whose subfertility was attributed to two or more major factors in the record, only one factor was reported by the women. Older age at the time of filling out the questionnaire, low educational level, long duration of subfertility, and pre–in vitro fertilization treatment were associated with less accurate reporting. The results indicate that the validity of self-reports for tubal and male subfertility is satisfactory. For unexplained subfertility, the validity is moderate; for other causes of subfertility and when two causes of subfertility play a role, the validity is low.

Keywords: cohort studies; fertility; fertilization in vitro; medical records; questionnaires; reproductive techniques, assisted; sensitivity and specificity; women; OMEGA, Ovariële hyperstiMulatie En Gynaecologische Aandoeningen

Journal Article.  5283 words.  Illustrated.

Subjects: Public Health and Epidemiology

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