Distance to fertility services impacts access to care in US

Approximately one in seven women must travel more than 60 miles to access fertility services in the United States, researchers reported at the ASRM Scientific Congress & Expo.

“The basic idea of this study is to understand what is the geographic distance women would need to travel in case they need to access fertility services, and what is the population affected by this travel distance,” author Urbano L. França, PhD, instructor at Harvard Medical School and Boston Children’s Hospital, said during the presentation.

Women who make repeated visits to distant centers see increased financial strains as well as adverse effects on their professional and personal lives, the researchers said.

The researchers based their analysis in part on the 2018 dataset from the Society for Assisted Reproductive Technology (SART), as well as the U.S. Census.

According to the study, 304,085 cycles were performed in the U.S. in 2018, or 5.68 per thousand women. One of the metrics used in the study — the numbers of clinics per million women — was consistent across U.S. regions, but the median distance to fertility centers varies from 33 miles in the Northeast to 52 miles in the South, 69 miles in the Midwest and 95 miles in the West.

“Basically, there’s a huge variability by region,” Urbano said. “The Midwest, South and West have a huge portion of women who live far away from fertility services.”

The researchers also noted a negative association between the median distance to fertility centers and the number of cycles per thousand women among states. On average, a 10-mile distance increase was associated with 370 fewer cycles per million women. Results also showed that 7.4 million (13.9%), or approximately one in seven women, live more than 60 miles from a fertility center.

Based on these findings, the researchers said, the concentration of fertility services should be considered when recommendations are made and policies are developed to expand access to fertility care in the U.S., especially for rural populations.