Survey highlights increasing need for fertility services in US
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Key takeaways:
- Most survey respondents cited concerns about a lack of fertility services in the U.S.
- Respondents said the number of graduating reproductive endocrinology and infertility fellows should increase to meet demand.
NEW ORLEANS — In a new survey, most respondents cited concern that there are not enough reproductive endocrinology and infertility specialists to meet the current demand for assisted reproductive technology in the U.S.
Sixty-eight percent of survey respondents said assisted reproductive technology (ART) capacity in the U.S. must be increased, according to results presented at the ASRM Scientific Congress & Expo.
“This project was to assess the perceived need for increased availability of fertility services in the U.S. and some proposed solutions,” Elizabeth Clain, MD, instructor and fellow in the department of obstetrics and gynecology at the University of Colorado School of Medicine, said during the presentation.
Clain and colleagues administered an anonymous online survey from 2022 to 2023 that was sent to 654 members of the ASRM and Society for Reproductive Endocrinology and Infertility (SREI). Two-thirds of respondents self-identified as reproductive endocrinology and infertility (REI) physicians or fellows.
Overall, 74% of respondents reported at least a 2-week wait period for new patient consults for fertility services and more than 40% of respondents reported an average wait time of longer than a month. Regarding travel for such services, 29% of respondents estimated an average travel distance of more than 20 miles for patients. Fifty-four percent of respondents reported that at least 25% of patients must travel more than 30 minutes for follicular monitoring and/or retrieval.
Many respondents reported working in practices with non-REI providers. Seventy-four percent of respondents work with advanced practice providers (APPs) and 18% general OB/GYNs. However, most respondents said they believe that APPs and OB/GYNs should not perform ART procedures or high-complexity consults or decision-making.
The majority of respondents supported standardized credentialing for APPs and OB/GYNs who do ART procedures and/or guidance from the ASRM, SREI and/or the Society for Assisted Reproductive Technology. Forty-nine percent of respondents reported that non-ART surgical cases should be referred to other providers.
In other results, 78% of respondents said the number of graduating REI fellows should increase, and 35% supported decreasing fellowship length to 2 years. When asked about fellowship options, 42% of respondents favored the option of 3- and 2-year fellowship options, and 68% favored the option of a specialized REI track in addition to a 2-year fellowship. Thirty-seven percent of respondents said fellowship requirements should be reduced to allow private practices to have fellowships; 38% disagreed and 25% remained neutral.
“There was a broad agreement that ART capacity needs to be increased. Incorporating non-REI trained providers into practices, particularly APPs, is already common,” Clain said. “Most respondents believe that non-REI trained providers should not do ART procedures or perform complex consults or decision-making, although do agree that it’s appropriate to do low-tech treatment.”