Last June, the American Medical Women’s Association (AMWA) hosted the first-ever Physician (In)Fertility Summit, which examined the fertility challenges facing women physicians.
In the United States, nearly 1 in 4 women physicians report a diagnosis of infertility — that’s nearly twice the rate reported in the general population. The AMWA Summit spotlighted the likely reasons, including the tendency for women physicians to delay childbearing due to the extended years of medical training, which usually coincide with their most fertile years plus the demanding and often emotional and stressful nature of that training, which in itself can negatively affect fertility outcomes.
Medicine is a fascinating, giving career and women individually and collectively bring invaluable skills and inspiration to patient care. Our healthcare systems need women physicians and women in medicine deserve the opportunity to realize their family-building aspirations. Thus, we need to provide both students and physicians with the practical, emotional and financial resources to help them anticipate and meet their family building goals.
AMWA became more fully engaged in the fight for physician fertility support in recent years, when data emerged on the prevalence of infertility among women physicians. Responding to a “Call to Action,” AMWA organized a Physician Fertility Committee to create awareness and drive change. With over 100 members and 4 subcommittees, this group focuses on education, research, advocacy, and outreach.
Leaders among this group include Dr. Christina Yannetsos, whose advocacy story began with her first visit to a reproductive endocrinologist when she was presented with treatment recommendations totaling $25,000. As a recent residency graduate still saddled with student loans and a former international athlete who had been reassured that her menstrual irregularities were normal, Dr. Yannetsos felt that the system had failed her. No one up until that time had ever mentioned fertility concerns. She knew then that she had to make a change in the system.
“Make sure that you use your voice. Make sure that you get personal. Make sure that you are persistent. You are one person that can make a change,” said Christina Yannetsos, MD.
Through various networks, she built a coalition of diverse stakeholders, including a political ally who had been through IVF. Within a year, they helped pass the first of several bills in Colorado that improved fertility benefits. The most recent bill was signed into law last week.
Dr. Yannetsos’ state advocacy led to institutional advocacy and gaining benefits for hundreds of thousands of people
During AMWA’s 2021 Physician Fertility Summit, Dr. Yannetsos outlined important steps in the advocacy process:
- Find your tribe, build a coalition, find political allies. These might include infertility support groups, reproductive endocrinology clinics, donor egg groups, ART attorneys and professional organizations.
- Get personal, arm yourself with knowledge and data because data drives change. Know the statistics on prevalence, including differences based on race and ethnicity.
- Be firm, and persistent, make your ask, and follow up. Keep asking.
- Institutional advocacy can lead to state advocacy which can, in turn, further support institutional advocacy.
Dr. Erica Kaye’s story developed more slowly. Ultimately, she ended up channeling a decade of personal grief into her advocacy.
“It took me several years of grieving my infertility journey and our pregnancy losses to feel empowered and to be able to step into that vulnerability. Translating that grief into advocacy work helped me find meaning in our journey,” said Dr. Erica Kaye, MD.
Dr. Kaye recognized that those in decision-making leadership roles would be most influenced by data, projected cost savings, and improved employee recruitment and retention strategies. Using the medical literature and resources from AMWA partner RESOLVE: The National Infertility Association and other groups, Dr. Kaye crafted a data-driven argument for why infertility matters in medicine, which was published in the New England Journal of Medicine. She also wrote op-eds and empowered colleagues and friends to raise awareness through existing avenues for communication — institutional surveys, newsletters, and town halls. Within 12 months of this multifaceted effort, her institution adopted comprehensive fertility coverage for all faculty and staff. The momentum has now been leveraged into a statewide movement for fertility coverage.
Dr. Kaye also participated in AMWA’s 2021 Fertility Summit, where she shared four important pillars of her advocacy:
- Persistence. Create a data-driven argument and keep asking.
- Vulnerability. Stories help give a face to the data. Sharing stories also empowers others to share their stories and opens up the dialogue. One voice is meaningful but many voices in aggregate, particularly in a coordinated wave, can move mountains. Stories about iatrogenic infertility can also help state level efforts, particularly when addressing the needs of cancer survivors, who otherwise might not have viable options for fertility preservation.
- Courage. One voice can make a difference.
- Community. Invite colleagues and friends to support your efforts.
Drs. Yannetsos and Kaye have also participated as speakers in AMWA’s Physician Fertility Seminar Series this year. To hear them discuss how advocacy can have an impact, click here to register for our free Fertility Seminar Series and access the recording of Seminar #2, Advocating for Change at Your Institution: Taking Action to Get Fertility Benefits Coverage, which took place on February 28, 2022.
Drs. Yannetsos and Kaye are just two of the remarkable women physicians who have contributed to AMWA’s Physician Fertility Committee over the last few years.
Today, we offer the stories of Drs. Kaye and Yannetsos as proof that advocacy can drive very meaningful change. We encourage members and other readers to consider taking up the torch and using the practical tools that AMWA has developed to help advocates in their journey.
Visit our 2022 National Infertility Awareness Week webpage for information about how you can get involved, so that together we can change the culture and promote practical support for women physicians interested in family building. Look, particularly, at the AMWA-RESOLVE Coverage at Work Toolkit and our guide on how to write and place an op-ed in your local newspaper or other news media outlet. Seeing many op-eds placed over the coming weeks would be a meaningful measure of success in our ongoing efforts to help drive change, not just for women physicians, but for all. Join our 3rd Fertility Seminar on April 25: Creating a Reproductive Life Plan, and stay posted for the Proceedings from the Physician Fertility Summit to be released next week.
Click here for the April 25 Fertility Seminar and for more information about AMWA fertility initiatives on the AMWA Physician Family Building Campaign webpage.