More than one in eight couples of childbearing age have difficulty conceiving or carrying a pregnancy to term, according to the Centers for Disease Control and Prevention. Experts at the World Health Organization (WHO) and the American Society for Reproductive Medicine (ASRM) have designated infertility a disease. In 2017 the American Medical Association (AMA) finally recognized infertility as a distinct disease process. This declaration may have a broader impact on how patients, insurers and society approach infertility.
Causes of infertility are present in both men and women, with about 40 percent of all infertile couples demonstrating a combination of factors. And in about 15 percent of couples, no dysfunction or abnormality can be identified, making a definite diagnosis difficult (so called unexplained infertility). Additionally, infertility in both men and women leads to a decline in many quality-of-life metrics, including psychological effects and sometimes a stigma of social isolation. The good news is that early treatment of infertility, ranging from simpler alternatives to ART, results in successful outcomes (live births), and significantly improves these metrics.
Some of the largest health insurance companies in the U.S., including Cigna, Optum Health and Aetna, cover some infertility treatments. However, not all insurance companies cover treatment. Undoubtedly our field has made tremendous advances in the management of infertility, and as we celebrate IVF’s 40th birthday we remain hopeful that the AMA declaration may promote and expand insurance coverage and payment.
Importantly, it has also been recognized that reproduction affects health and health affects reproduction. There is consensus that infertility may be a sign or indicator of future health risks. A well understood link exists between PCOS (polycystic ovarian syndrome) and medical co-morbidities such as diabetes, dyslipidemia, obesity, endometrial cancer, and cardiovascular disease. All these factors need to be considered in the reproductive years and beyond. Similarly, there is evidence of an association of diminished ovarian reserve and ovarian aging with cardiovascular disease. Also, male infertility can be a signal of future health for men, as links are found between semen quality and male infertility and cancer risk, as well as cardiovascular and metabolic health problems.
These associations highlight that a diagnosis of infertility may identity a risk population, and that potential early interventions can be implemented in terms of surveillance and hopefully prevention of future disease. At Sher Fertility Institute New York we will guide you to fertility treatments with a holistic, health conscious approach.
Contact Sher Fertility Institute New York at 646-792-7476 or click here to schedule an appointment with one of our fertility doctors. Our Patient Care Specialists will contact you within the next 24 hours.