Utilizing a cross-national approach, University of Arizona researcher Leslie Farland, ScD is conducting a study on infertility rates and long-term health outcomes in Mexican women through a collaboration with Mexico’s Instituto Nacional de Salud Pública alongside co-investigator Dalia Stern Solodkin, Ph.D. 

Farland, an associate professor of epidemiology and biostatistics at the Mel and Enid Zuckerman College of Public Health at the UA, and her collaborator Stern, a researcher at the INSP, were recently awarded a $2.2 million grant from the National Institute of Health. They used this grant money to investigate the adverse healthcare outcomes in women of Mexican heritage related to infertility.

“We see associations between infertility and certain types of cancer, specifically breast, ovarian and endometrial cancer. We also see an increased risk of heart disease, but all of the research to date has predominantly been done on non-Hispanic white women,” Farland said. “Hispanic women actually are more likely to experience infertility, and some of the diagnoses that cause infertility [such as polycystic ovary syndrome, or PCOS] present in a more severe manner in Hispanic women.”

Lack of access to infertility care disproportionately affects Hispanic women due to barriers such as geographical and economic factors along with cultural circumstances. Additionally, even when women of Hispanic origin do receive an infertility consultation, there is still a lack of infertility treatment. 

“When we looked at all of the existing cohort studies in the United States, we realized that there’s no current study that exists that has enough Hispanic women, collected enough detailed information on infertility and has followed participants long enough to see if they will develop cardiovascular disease and cancer,” Farland said. “Infertility and reproductive risk factors [occur] in [the] 20s, 30s and even 40s, but cardiovascular disease and mortality happen for most people in their 50s, 60s and 70s.”  

Previous research has shed light onto the economic barriers of accessing infertility treatment as well as certain racial disparities, however, there is not a significant amount of information on lifestyle and cultural factors in relation to infertility care. 

“There is very little understanding of whether the risk of developing adverse healthcare outcomes related to infertility also happens in different populations such as Hispanic women,” Stern said. “In the United States, even though Hispanics are the largest minority, there seems to be no data available to study these questions.”

Farland and Stern’s study uses data from the Mexican Teacher’s Cohort, which includes information on medical and lifestyle factors from over 115,000 female teachers across Mexico. 

According to Farland, the study began in 2006.

“Those women have been followed subsequently since to monitor their health status over time,” Farland said. “We’ve asked them detailed questions previously about experiencing infertility and other gynecologic conditions. Now, we’re following them over time to see whether or not they develop outcomes [such as] cancer, cardiovascular disease, and also mortality.”

Farland and Stern will be analyzing survey data, linkages to electronic healthcare records, death certificates and the cancer registry of the Mexican Teacher’s Cohort, which involves follow-ups for this information every three years. 

“One of the novel aspects of is that we are [conducting] the study with this existing cohort, but we’re also hoping to use some novel statistical techniques to think about how we could reweight the population of participants that we have in Mexico to be representative of Hispanic women in the United States,” Farland said.

“This study provides an incredible opportunity to first study [our] question and also utilize advanced methodological techniques to answer the question about infertility and long-term health outcomes,” Stern said. 

Through their investigation, Farland and Stern’s research can provide the first pieces of evidence regarding the relationship between infertility and these health outcomes in an attempt to improve the health of Hispanic women in clinical care within the United States and beyond.

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