Approximately 25 million reproductive aged women in the United States (nearly 40 percent), have limited or no nearby access to assisted reproductive technology (ART) clinics. These clinics provide services that are vital to many women wanting to become pregnant. Results of the study done at the University of Pittsburgh were published in Fertility & Sterility.
While a woman’s obstetrician or gynecologist can perform basic infertility evaluations and ovulation induction treatments, only more specialized providers in ART clinics offer advanced procedures such as in-vitro fertilization. Marie Menke, M.D., M.P.H., and John Harris, M.D., M.Sc., the study authors, are both assistant professors of gynecology, obstetrics and reproductive sciences at Pitt’s School of Medicine and the Magee-Womens Hospital of UPMC. They, together with co-authors from the University of Michigan, evaluated women’s access to infertility care in the U.S by using federal data on where infertility clinics are located versus where women live.
The research team used data from the 2010 U.S. Census and from the Centers for Disease Control and Prevention to locate 510 ART clinics and obtain population numbers in the United States. They established that 18.2 million women 20 to 49 years old (29% of that population) live in metropolitan areas where there are no ART clinics. Another 6.8 million women (11% of the 20 to 49 year old population) live in areas with only a single ART clinic and therefore have no choice of a provider. The remaining 38.1 million women (60% of the population) live in regions with multiple ART clinics, allowing them to use ART services from a provider that they choose.
Harris noted that infertility is a difficult issue for couples to face, both from a financial and from an emotional perspective. Depending on geography, many couples trying to start families have only one clinic nearby where these services are available, while many women with infertility do not have access to these services nearby at all. This adds extra anxiety during an already stressful time of life.
As it is unknown how far patients would be willing or able to travel for these services, the findings from this study might warrant further research and consideration to investigate additional questions about access to ART services. Other uncertainties include whether the U.S. Census metropolitan areas used in the study are an accurate reflection of where patients would contemplate seeking treatment. Other factors that need to be investigated include how much money and time patients would be willing to spend on reproductive services, and how these barriers interrelate with other demographic differences, including age, race and socioeconomic status.