Article Text

Original research
Risk factors for resignation from work after starting infertility treatment among Japanese women: Japan-Female Employment and Mental health in Assisted reproductive technology (J-FEMA) study
  1. Yuya Imai1,
  2. Motoki Endo1,
  3. Keiji Kuroda2,3,
  4. Kiyohide Tomooka1,
  5. Yuko Ikemoto2,
  6. Setsuko Sato1,
  7. Kiyomi Mitsui4,
  8. Yuito Ueda1,
  9. Gautam A Deshpande5,
  10. Atsushi Tanaka6,
  11. Rikikazu Sugiyama3,
  12. Koji Nakagawa3,
  13. Yuichi Sato7,
  14. Yasushi Kuribayashi8,
  15. Atsuo Itakura2,
  16. Satoru Takeda2,
  17. Takeshi Tanigawa1
  1. 1Department of Public Health, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
  2. 2Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
  3. 3Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Shinjuku-ku, Tokyo, Japan
  4. 4Department of Hygiene, Public Health, and Preventive Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
  5. 5Department of General Internal Medicine, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
  6. 6Saint Mother Hospital Infertility Clinic, Kitakyushu, Fukuoka, Japan
  7. 7Takasaki Art Clinic, Takasaki, Gunma, Japan
  8. 8Center for Reproductive Medicine and Endoscopy Sugiyama Clinic Marunouchi, Chiyoda-ku, Tokyo, Japan
  1. Correspondence to Professor Takeshi Tanigawa, Department of Public Health, Juntendo University Graduate School of Medicine, Bunkyo-ku 113-8421, Japan; tt9178tt9178{at}


Objective To elucidate the risk factors associated with resignation from work of Japanese women undergoing infertility treatment.

Methods A total of 1727 female patients who attended a private fertility clinic in Japan participated in the Japan-Female Employment and Mental health in Assisted reproductive technology study. Questions related to demographic, clinical and socioeconomic characteristics were employed in the questionnaire. Out of the 1727 patients, 1075 patients who were working at the time of initiating infertility treatment and felt infertility treatment incompatible with work were included in the analysis. Risk factors for resignation were assessed by using multivariable logistic regression models.

Results Among 1075 working women who started infertility treatment, 179 (16.7%) subsequently resigned. Multivariable-adjusted ORs for resignation in those with lower educational background and infertility for ≥2 years were 1.58 (95% CI: 1.07 to 2.34) and 1.82 (95% CI: 1.15 to 2.89), respectively. The OR for resignation in non-permanent workers undergoing infertility treatment was 2.65 (95% CI: 1.61 to 4.37). While experiencing harassment in the workplace approached significance, lack of support from the company was significantly associated with resignation after starting infertility treatment, with ORs of 1.71 (95% CI: 0.98 to 2.99) and 1.91 (95% CI: 1.28 to 2.86), respectively.

Conclusion One-sixth of women resigned after starting infertility treatments. It was found that factors related to education, infertility duration and work environment were significantly associated with resignation. Reducing the physical and psychological burden endured by women, for example, by increasing employer-provided support, is vitally important in balancing infertility treatment with maintenance of work life.

  • occupational health practice
  • obs and gynae
  • cross sectional studies
  • women
  • sickness absence

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  • Contributors IY provided substantial contribution to the conception, analysing data, drafting of the manuscript. ME contributed to the substantial design of the work, acquisition of data, drafting of the manuscript and critical revisions and obtained the funding of the study. KK contributed to the design of the work and made critical revisions. KT contributed to the analysis of data and also participated in the critical revisions in the paper. YI helped in the analysis of data and made critical revisions. SS helped in the interpretation of the data and critical revision. KM contributed to the interpretation of data and critical revision. YU, GAD, AI, ST and TT helped in the interpretation of data and critical revision. AT, RS and YK contributed to the acquisition of data and critical revision. KN and YS helped in the acquisition of data and critical revision of the paper.

  • Funding This study was supported by a Grant-in-Aid for Scientific Research from ‘KAKENHI’ (grant number: 18K17395) to ME.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study protocol was reviewed and approved by the Ethics Review Committee of Juntendo University Graduate School of Medicine (No. 18–008, Tokyo, Japan).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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