Too much time? Time use and fertility-specific quality of life among men and women seeking specialty care for infertility.


BACKGROUND:There are known gender differences in the impacts infertility has on quality of life and well-being. Less is known about how infertile couples spend time on fertility-related tasks and associations with quality of life. The purpose of this study is to evaluate whether time spent on tasks related to family-building decision-making (including research, reflection, discussions with partner, discussions with others, and logistics) were associated with fertility-specific quality of life or anxiety among new patients. METHODS:Couples or individuals (N = 156) with upcoming initial consultations with a reproductive specialist completed the Fertility Quality of Life (FertiQoL) tool, which produces a Core (total) score and four subscales: Emotional, Relational, Social, and Mind-Body. We developed questions to measure time spent in the previous 24 h on tasks related to family-building. We tested for differences by gender in time use (McNemar's Test) and used ordinary least squares regression to analyze the relationship between time use and FertiQoL scores. RESULTS:In the week before a new consultation, a higher percentage of women reported time spent in the past 24 h in research, reflecting, discussion with others, and logistics compared to male partners (all p < 0.05). In adjusted models, more time spent reflecting was associated with worse FertiQoL scores for both men and women, as well as with higher anxiety for men. Time spent in discussion with others was associated with higher anxiety for women but better Social FertiQoL scores for men. CONCLUSIONS:Couples seeking infertility consultation with a specialist reported spending time on tasks related to family-building before the initial visit. There were gender differences in the amount of time spent on these tasks, and time was associated with fertility-specific quality of life and anxiety.





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Publication Info

Cusatis, Rachel, Nicole Fergestrom, Alexandra Cooper, Kate D Schoyer, Abbey Kruper, Jay Sandlow, Estil Strawn, Kathryn E Flynn, et al. (2019). Too much time? Time use and fertility-specific quality of life among men and women seeking specialty care for infertility. BMC psychology, 7(1). p. 45. 10.1186/s40359-019-0312-1 Retrieved from

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Alexandra Cooper

Manager, Program Assessment

Alexandra Cooper serves as Associate Director for Evaluation and Assessment within the Purpose Project in the Kenan Institute for Ethics.  She supports the Project in making question of character, purpose and meaning signature features of the Duke community by gathering evidence about the Project's programs and their effects and by working with Project team members to examine and understand what that evidence shows us about what the Project does and can accomplish.

Prior to joining the Purpose Project she worked at Duke's Social Science Research Institute, first as its Administrative Director and subsequently as its Associate Director for Education and Training.  She has guided and directed a wide range of collaborative educational programming and services and devoted  effort to a wide range of research projects, supporting both quantitative and qualitative data collection, management, analysis, and reporting.  Prior to coming to Duke, she held faculty positions at Lafayette College and the University of North Carolina - Charlotte.  She holds a B.A. in Political and Social Thought and in French from the University of Virginia and a Ph.D. in Political Science from the University of North Carolina - Chapel Hill.


Kathryn Eve Flynn

Adjunct Professor in the Department of Population Health Sciences

Kathryn E. Flynn, PhD, is an adjunct assistant professor in psychiatry and behavioral sciences at the Duke University School of Medicine. She works primarily at the Duke Clinical Research Institute.

Dr. Flynn was trained in sociology and population health sciences at the University of Wisconsin, where she worked with Maureen Smith on the development and fielding of new survey instruments to assess health care access and utilization in the near elderly as part of the Wisconsin Longitudinal Study, a long-term cohort study with over 10,000 participants. In 2005, Dr. Flynn was awarded an R36 dissertation grant from the Agency for Healthcare Research and Quality to use the Wisconsin Longitudinal Study to examine preferences for health care decision making among older adults. Findings from this research have been published in Social Science and Medicine and the Journal of General Internal Medicine. As a postdoctoral fellow at the Duke Clinical Research Institute, Dr. Flynn trained under Kevin Weinfurt, gaining experience in the design and analysis of patient-reported outcomes in clinical trials.

Dr. Flynn's research interests include shared medical decision making; patient-provider relationships, including communication, trust, and technology; quality of medical care; patient-reported outcomes in clinical trials; and quantitative and qualitative methods in behavioral research.

Areas of Expertise: Health Measurement, Health Services Research, and Health Behavior

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