Infertility: Disparities and Access to Services
Summary of Recommendations and Conclusions
- 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
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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