He said, she said: How third-party presence shapes infertility reporting in couples

Background: Estimating infertility prevalence at the population level is challenging and little is known about the factors that influence how individuals report it. Objective: We assess whether third-party presence, such as that of a partner, influences the likelihood of reporting infertility among a sample of heterosexual couples. We also examine the consistency of responses between partners interviewed separately and evaluate whether third-party presence increases agreement or disagreement within couples. Methods: Using data from the 2019 Household, Income and Labour Dynamics in Australia Survey, we apply descriptive statistics and logistic regression models to assess associations between third-party presence and (1) infertility reporting and (2) consistency of infertility reports between partners. Results: Overall, 10.1% of men and 16.1% of women reported infertility. When a third party actively influenced the interview, reported infertility increased to 16.7% among men and 21.4% among women. After adjustment for confounders, men interviewed in the presence of an influencing third party had more than twice the odds of reporting infertility, while women had 65% higher odds. Agreement on infertility between partners increased from 7.5% to 14.5% in men’s interviews and from 7.1% to 13.7% in women’s interviews when a third party was present. Adjusted models show that joint infertility reporting was more than twice as likely in the presence of an influencing third party. Contribution: Interview context influences both the likelihood and framing of infertility reporting. The findings suggest that third-party presence matters for the measurement of sensitive and subjective outcomes that are jointly experienced within couples.