Infertility is increasingly common in the United States, affecting approximately 9% of men and 11% of women of reproductive age.
In the United States, about 9% of men and 11% of women of reproductive age experience fertility challenges, according to the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Infertility is characterized as the inability to become pregnant after 12 months of regular, unprotected sexual intercourse. Despite infertility having similar rates between female-related and male-related factors, infertility is more often viewed as a women’s health issue.
Infertility can be an isolating, stigmatizing experience. Therefore, being transparent about your feelings — with yourself, your partner, and your providers — is crucial to receiving the care and support you need. Patient-centered care and shared decision-making are particularly important for successfully navigating reproductive health and infertility care.
Patient-centered care and shared decision-making
The National Academies (formerly Institute of Medicine) defines patient-centered care as care that is respectful of and responsive to individual patient preferences, needs, and values guiding all clinical decisions. When it comes to fertility care, providers should consider the pregnant patient as well as other key individuals involved in the fertility journey; cultural preferences, influences, and beliefs; language and health literacy level; gender identity and/or sexual orientation; current health and medical history; fertility goals and past experiences; and other social determinants of health, such as financial stability and environment, that may impact care and well-being. The SWHR Clinician Resource Guide to Fertility Health Care outlines these topics and more for engaging in patient-centered discussions around fertility.
In open conversations, patients may feel more empowered to speak up about their care and engage in shared decision-making. The National Cancer Institute defines shared decision-making as the process in which both patients and health professionals work together to decide the best plan of care for the patient. Just as there are several factors that can affect fertility, there is a wide range of treatments to address many of them — from medication and surgery to intrauterine insemination (IUI) and in vitro fertilization (IVF) — and research continues to innovate.
Surgical options are less common due to the high success rates of other treatments; however, surgery can help correct physical issues with the uterus or fallopian tubes. Fertility drugs for women alter hormone levels to help regulate or stimulate ovulation, and IUI is a technique that places sperm directly into the uterus to help with fertilization. IVF is another type of assisted reproductive technology that involves removing eggs and sperm from two individuals and combining (fertilizing) them in the laboratory before transferring the embryo(s) into the uterus. Explore the SWHR Women’s Resource Guide to Fertility Health Care to learn more about treatment and coverage options that may be available for your own fertility care.
We must keep in mind, however, that even with treatment, conceiving can take time. Some treatments may need multiple attempts before ruling out their probability of individual success. Even after a treatment is selected and started, patients should keep communicating with their providers about any questions or concerns throughout the process. The work of patient-centered care and shared decision-making is an ongoing effort.
Be your own advocate
To all my women reading this: When it comes to your health, and especially your reproductive health, do not be afraid to speak up for yourself and advocate for any concerns related to your age, faith, culture, sexual orientation, or other personal preferences. If you desire another perspective on your infertility diagnosis, care, and/or treatment options, do not hesitate to seek a second opinion.
With millions of women and men experiencing infertility each day, it is up to all of us to ensure that care options are made clear, support is accessible, and patients are at the center of and actively involved with every decision.
