Infertility: Disparities and Access to Services

Publication Date: December 12, 2024
Last Updated: December 18, 2024

Summary of Recommendations and Conclusions

Based on the principles outlined in this Committee Statement, the American College of Obstetricians and Gynecologists (ACOG) makes the following recommendations and conclusions regarding infertility in historically and intentionally excluded communities:
  • Patients with infertility have a medical disease (not a “social condition”), and health care professionals should provide medically and ethically sound care specific to the etiology of a patient’s diagnosis.
  • Obstetrician–gynecologists should ask all patients about reproductive planning and attempts at pregnancy.
  • Obstetrician–gynecologists and other health care professionals should understand the circumstances in which immediate referrals to subspecialists in reproductive endocrinology and infertility are necessary.
  • Obstetrician–gynecologists and other health care professionals should identify specific populations at risk and their accompanying barriers to access to help improve infertility care across populations.
  • Obstetrician–gynecologists and other health care professionals should recognize that social determinants of health greatly influence access to care and should strive to identify and mitigate self-bias and systemic barriers to equity in access and care.
  • Obstetrician–gynecologists and other health care professionals should collaborate with local and national agencies to provide support for individuals diagnosed with infertility.
  • Obstetrician–gynecologists and other health care professionals should advocate for insurance coverage for infertility services, including assisted reproductive technology, policy changes that promote comprehensive reproductive health, and evidence-based lower cost treatment options.
  • Obstetrician–gynecologists and other health care professionals should intentionally provide patient education about fertility and infertility.
  • Continued research is needed to identify strategies to improve outcomes for individuals with infertility, especially in communities with barriers to access to infertility services.

Recommendation Grading

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Overview

Title

Infertility: Disparities and Access to Services

Authoring Organization

American College of Obstetricians and Gynecologists

Publication Month/Year

December 12, 2024

Last Updated Month/Year

December 18, 2024

Document Type

Consensus

Country of Publication

US

Document Objectives

Diagnostic testing and treatment for infertility should be available to everyone in need of these services. The disparities in rates of infertility and the barriers to accessing assisted reproductive technology services should be understood through and addressed within a reproductive justice framework. Obstetrician–gynecologists and other health care professionals should identify specific populations at risk and their accompanying barriers to access to help improve infertility care across populations. Health care professionals should ask appropriate questions about social and structural drivers of health that may influence a patient’s health and use of the health care system to better understand their patients’ needs and lived experiences. Obstetrician–gynecologists and other health care professionals should advocate for insurance coverage for infertility services, including assisted reproductive technology; policy changes that promote comprehensive reproductive health; and evidence-based, lower cost treatment options.

Inclusion Criteria

Female, Adult, Childbearing

Health Care Settings

Ambulatory

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Management

Diseases/Conditions (MeSH)

D007246 - Infertility, D007247 - Infertility, Female, D054625 - Healthcare Disparities

Keywords

infertility, health disparities

Source Citation

Infertility: Disparities and Access to Services: ACOG Committee Statement No. 14. Obstet Gynecol. 2025 Jan 1;145(1):e51-e57. doi: 10.1097/AOG.0000000000005769. PMID: 39666991