Factors influencing infertile couples' decisions to seek healthcare: A mixed methods study from Islamabad, Pakistan

This study examines the factors influencing the decision-making of infertile couples to seek healthcare, focusing on socio-demographic characteristics and barriers to accessing care. The study uses a mixed-methods approach, including in-depth qualitative interviews (IDIs) and a cross-sectional survey of women experiencing infertility. A hospital-based cross-sectional study was conducted from July to December 2024, including 269 participants, along with in-depth interviews with 12 women seeking infertility treatment. Qualitative findings showed significant emotional distress among participants, with many feeling judged and inadequate. Social isolation and external stigma were common, worsening the emotional burden. Limited access and inconsistent support further increased the difficulties faced by infertile couples. Of the 269 participants, 43.9% reported primary infertility, and 56.1% secondary infertility. Most had been married for 1-5 years and had been delaying treatment for over three years. The main reason for seeking medical treatment was the inability to conceive, followed by family pressure. Financial constraints, lack of access, and social stigma were major barriers to healthcare. Regression analysis indicated that individuals with lower educational levels were less likely to seek healthcare than those with higher levels. Couples in joint families were more inclined to pursue treatment, and primary infertility was a key factor influencing the decision to seek medical care. Community-based awareness programmes are vital to dispel myths surrounding infertility, alongside counselling services to address emotional stress. Healthcare providers should receive training to offer empathetic support tailored to infertile couples. Furthermore, social health protection schemes should consider subsidized treatment or insurance coverage to alleviate financial burdens for low-income families in Pakistan.