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Disparities in access to effective treatment for infertility in the United States: an Ethics Committee opinion
Open accessAbstract
In the United States, economic, racial, ethnic, geographic, and other disparities prevent access to fertility treatment and affect treatment outcomes. This opinion examines the factors that contribute to these disparities, proposes actions to address them, and replaces the document of the same name, last published in 2015.
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“Accessibility and utilization are affected by physical features of clinics (e.g. access for the disabled, male services available only in female clinics), limitation of reproductive health information, and a regulatory environment that might restrict services and/or discriminate, e.g. LGBTQ+ or single people (ASRM The Ethics Committee, 2021; Oliveira et al., 2021).”
From Declining global fertility rates and the implications for family planning and family building: an IFFS consensus document based on a narrative review of the literature (2024) · cites this paper as ASRM The Ethics Committee, 2021
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“Distinct disparities in infertility care exist, largely due to barriers to access aligned with race, class, socioeconomic status, gender, sexual orientation, and other forms of difference (ASRM The Ethics Committee, 2021).”
From Declining global fertility rates and the implications for family planning and family building: an IFFS consensus document based on a narrative review of the literature (2024) · cites this paper as ASRM The Ethics Committee, 2021
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“Due to high cost and/or unaffordability, ART remains out of reach for many, even in resource-rich countries (Dyer et al., 2020; ASRM The Ethics Committee, 2021; Njagi et al., 2023).”
From Declining global fertility rates and the implications for family planning and family building: an IFFS consensus document based on a narrative review of the literature (2024) · cites this paper as ASRM The Ethics Committee, 2021
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“Distinct disparities in infertility care exist, largely due to barriers to access aligned with race, class, socioeconomic status, gender, sexual orientation, and other forms of difference (ASRM The Ethics Committee, 2021).”
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Navigating health insurance selection for in vitro fertilization (IVF) benefits: A study protocol
Dayo, O. M., Turcotte, V., Reyes, B. J., Ortega, R. E. F., Kaiser, B. N., Aarons, G. A., McMenamin, S. B., Su, H.-C. I., & Romero, S. A. D. (2025) · Contemporary Clinical Trials · doi:10.1016/j.cct.2025.107998 · Cited by 1
Collins, L. R. (2022) · F&S Reports · doi:10.1016/j.xfre.2022.11.003 · Cited by 1
Peipert, B. J., & Kawwass, J. F. (2023) · Fertility and Sterility · doi:10.1016/j.fertnstert.2023.04.024 · Cited by 1
Doody, K. J., & Doody, K. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108859486.002
Current options to lower the cost of in vitro fertilization: a comprehensive review
Gardner, A. B., Smith, K. L., Huuki, E., Luizzi, J. M., Gunn, D. D., Campbell, S. B., & Pier, B. D. (2022) · F&S Reviews · doi:10.1016/j.xfnr.2022.10.001
Frankel, R. A., Merkison, J. M., & DeCherney, A. H. (2023) · Reproductive medicine for clinicians · doi:10.1007/978-3-031-24903-7_6
Mandated fertility coverage: the resounding choice when morality, medicine, and money align
Klipstein, S., & Collins, L. R. (2023) · Fertility and Sterility · doi:10.1016/j.fertnstert.2023.08.017
Amplifying Diverse Narratives of Social Support in Online Health Design
Cameron, S. (2023) · Communication Design Quarterly · doi:10.1145/3592367.3592373
Impacts of COVID-19 on Medically Assisted Live Birth Rates in the United States in 2020 and 2021
Tierney, K., & Lazzari, E. (2024) · Population Research and Policy Review · doi:10.1007/s11113-023-09849-0
Roshong, A. J., Rosalik, K. F., Carson, S., Spilman, L., Luizzi, J. M., Plowden, T. C., & Pier, B. D. (2024) · F&S Reports · doi:10.1016/j.xfre.2024.06.001 · Cited by 1
Lee, N., Westphal, L. M., Schlegel, P. N., Eisenberg, M. L., Gaskins, A. J., Montgomery, N., Murdoch, E. M., & Richardson, M. (2024) · Women s Health Science Journal · doi:10.23880/whsj-16000228
Gibbs, L., Shoai, B., Becks, A., Yan, F., & Mitchell‐Leef, D. (2024) · Journal of the National Medical Association · doi:10.1016/j.jnma.2024.07.006
Hallisey, S. M., & Engmann, L. (2024) · Fertility and Sterility · doi:10.1016/j.fertnstert.2024.08.341
Race, ethnicity, and assisted reproductive technology outcomes: where do we go from here?
Diego, D. S., & Kawwass, J. F. (2024) · Fertility and Sterility · doi:10.1016/j.fertnstert.2024.09.020
Swanson, A. C., & Lawson, A. K. (2024) · Springer eBooks · doi:10.1007/978-3-031-67474-7_1
Recognizing and Ameliorating Provider Implicit Bias
Kaplan, D. A. (2024) · Springer eBooks · doi:10.1007/978-3-031-76204-8_18
Strategies for Culturally Responsive Practice Management
Wood, J. M. (2024) · Springer eBooks · doi:10.1007/978-3-031-76204-8_16
Metadata
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2021-07
- Volume
- 116
- Issue
- 1
- Pages
- 54-63
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W4205755962
- Cited by
- 125
- References
- 75
- Citations by year
- 2026: 19 · 2025: 29 · 2024: 29 · 2023: 27 · 2022: 15 · 2021: 4
- FWCI
- 16.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Society for Reconstructive Microsurgery
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
- Keywords
- access to fertility treatment, health disparities, racial and ethnic disparities, socioeconomic disparities, geographic disparities, treatment outcomes, health equity
- MeSH terms
- Race Factors, Female, Health Services Accessibility, Health Services Needs and Demand, Humans, Infertility, Insurance, Health, Male, Pregnancy, Risk Factors, United States, Treatment Outcome, Health Care Costs, Risk Assessment, Insurance Coverage, Reproductive Techniques, Assisted, Ethics Committees, Clinical, Healthcare Disparities, Social Determinants of Health
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