American Medical Women’s Association

Physician (In)Fertility Initiative

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Estimates suggest that 1 in 4 female physicians will experience infertility.
As physicians who have had to face the possibility of being “involuntarily childless,”
we firmly believe that everyone deserves the chance to have a family if and when desired.
We can and should feel prepared to manage a career and have a family as suits each of us.

— Drs. Ariela Marshall, Vineet Arora, Arghavan Salles

The Need

1. 1. 1. - 1 in 4 women physicians will face issues of infertility, which is double to rate of women in the general population.
      - Reproductive health issues, financial limitations, and the timing of motherhood impact career advancement and the physician workforce, as many women face the competing challenges of career advancement or building a family.
      - Knowledge is power. More than 53% of female physicians would have attempted to conceive earlier and 16.7% would have used cryopreservation to preserve fertility had they been aware that infertility might become an issue.
      - Though studies have not specifically explored fertility in male physicians, transgender physicians, single physicians, or physicians with same-sex partners, fertility issues are important for all physicians hoping to start a family.

Our Opportunity

“This is the journey of infertility. Huge highs and heart-wrenching lows, all accompanied by alternating hope and hopelessness. Once again, our only option is to pick ourselves up and try again.” —Ariela L. Marshall, MD (AM Rounds)

The problem of infertility among women physicians is not a single problem to be solved. There are myriad, complex, and varied barriers to successfully creating a safe space for women physicians and trainees to pursue family building to meet individual needs. Thus, a multi-pronged, long-term, comprehensive effort is required to make the necessary changes to reduce this risk.

The American Medical Women’s Association aims to bring the conversation out into the open in order to eliminate the common refrain of so many women physicians: “If only I knew then…” We are poised to change the culture of care around family-building in medicine and empower women physicians with the knowledge and tools to address fertility challenges, overcome barriers, and drive policy change on a local, regional, and national level. We will advance the conversation by addressing the issues head-on with insights, lessons learned, and tools to change the culture and gain the benefits —both health benefits and workplace flexibility with scheduling and time off—necessary to work and thrive as physicians who are also seeking to build a family.

Share Your Story Join Infertility Advocacy Join Infertility Education Join Infertility Research Physician Fertility Coaching Group

AMWA hosted the first Physician Fertility Summit in June 2021. This half-day conference brought together stakeholders from practitioners, patients, mental health specialists, industry, insurers, and others to discuss this important issue.

Learn more about the Physician Fertility Summit

We have adopted five strategies as part of our call-to-action:

1. 1. 1. 1. Awareness: Increase fertility education and awareness starting at the undergraduate medical education level and continuing throughout training and practice. Knowledge is power.
      2. Coverage at Work: Ensure there is insurance coverage for, and access to, fertility assessment and management, and treatment. Women physicians may be uniquely positioned to help advocate within their own institutions to improve fertility coverage benefits. Equip them with the tools that they need. Equip them and other allies with the tools that they need.
      3. Support system: Assure that there are physicians who can provide the empathy, understanding, and wisdom of having been there to guide those wanting information about and undergoing fertility treatments. This will go a long way to helping build a workforce that is healthy and well physically, emotionally, and financially.
      4. Research: Promote research that will show the long-term economic impact of addressing infertility needs, including the return on investment (ROI) for employers through improved workforce well-being and job satisfaction, workforce recruitment, and employee retention.
      5. Advocacy: Increase legislative efforts at the state and national levels to provide women physicians, in particular, and other underrecognized physicians facing fertility challenges, the resources needed to achieve changes in your institutions and utilize your positions to reach influencers and improve the culture of care around family-building in medicine.

Sources:

Kaye EC. N Engl J Med 2020; 382:1491-1493
Marshall AL, Arora VM, Salles A. Acad Med, 2020;95(5):679.
Stentz NC et al. J Womens Health. 2016;25:1059.
Chandra A et al. www.cdc.gov/nchs/ data/series/sr_23/sr23_025.pdf.
Kemkes-Grottenthaler A. J Biosoc Sci. 2003;35:213

In Partnership with RESOLVE: The National Infertility Association

Moving the Fertility Conversation Forward

The American Medical Women’s Association (AMWA) held the first-ever Physician Fertility Summit — convened at the urging of our members who expressed a desire to bring this common issue of infertility out into the open. We are committed to seeking solutions so no woman in medicine ever has to say, “I wish I knew then what I know now,” as Hina Talib, MD, said. Dr. Talib leads the AMWA Fertility Committee with co-chairs, Cindy Duke, MD, PhD, and Torie Comeaux Plowden, MD, MPH; together with the AMWA Physician Fertility Steering Committee, they are committed to changing the culture of medicine.

Learn more about the Physician Fertility Summit

We are dedicated to continuing to focus on physician infertility challenges through a series of actionable seminars. Seminar 1 focused on Navigating Difficult Conversations and Seminar 2 invited women in medicine to change the culture of medicine through advocacy at work and in state legislation to make fertility treatment required in healthcare coverage; this work continues so join us. Watch Seminar 2 to get inspired, then download the advocacy toolkit so you can join us in this effort.

Seminar 3

Creating a Reproductive Life Plan

Anticipating Your Needs and Planning for the Future

April 25, 2022 @ 8 pm ET

Moderator:

1. 1. 1. - Torie Comeaux Plowden, MD, MPH, AMWA Fertility Co-Chair
        Chief of Gynecologic Surgery & Obstetrics, Womack Army Medical Center, Washington, DC

Panelists:

1. 1. 1. - Jerrine Morris, MD, a clinical fellow in Reproductive Endocrinology & Infertility at UCSF
      - Kiley Hunkler, MD, Physician who achieved pregnancy during residency

Breakout Session to explore:

1. 1. 1. - Considerations in timing pregnancy
      - Anticipating what life looks like with child(ren)
      - Addressing what it means to shift priorities

The Physician Fertility Conference 2022 has been made possible through the generous support of our
Gold level sponsors—Ferring Pharmaceuticals and Progyny— and Bronze level sponsor, ARC Fertility

Seminar 2

(Held February 28, 2022)

Advocating for Change at Your Institution
Taking Action to Get Fertility Benefits Coverage

WATCH NOW [] [/]Coverage at Work Toolkit

Moderator:

1. 1. 1. - Barbara Collura, President/CEO, RESOLVE: The National Infertility Association

Invited Speakers:

1. 1. 1. - Erica C. Kaye, MD, Pediatric Oncologist, St. Jude Children’s Research Hospital. Successful Strategies in a Healthcare System
      - Christina Yannetsos, MD, Assistant Professor at the University of Colorado Medical Campus; and, Founder, Colorado Fertility Advocates. Taking Your Message to Your State Legislators
      - Chrissy Guidry, DO, Assistant Professor of Surgery, Tulane University. Lessons Learned in an Academic Institution

Breakout Sessions:

1. 1. 1. - Writing letters-to-the-editor/Op-Eds
      - Role-playing pitch to HR for fertility benefits
      - Advocating for fertility to be included as essential benefits in state healthcare plans

Seminar 1

Held January 24, 2022

Navigating Fertility-Related Conversations at All Stages of Your Career

Strategies to help you talk about infertility, develop a support system, and learn from others.

WATCH NOW

Moderator:

1. 1. 1. - Arghavan Salles, MD, PhD, Senior Research Scholar at Stanford University. Full Bio

Speakers:

1. 1. 1. - Dana Reddy, MD, Rheumatology Physician in Private Practice and with the Family Health Centers of San Diego and San Ysidro Health Center. Full Bio
      - Kate Hoppock, DO, Internist/Hospitalist at Duly Health and Care. Full Bio
      - Amelia Swanson, PhD, Assistant Professor of Clinical Obstetrics & Gynecology and Psychiatry at Northwestern University Feinberg School of Medicine. Full Bio

Breakout Sessions:

1. 1. 1. - Finding words that work
      - Developing support systems
      - Connecting to resources

Social Media Toolkit – General, Student

The Physician Fertility Conference 2022 has been made possible through the generous support of our
Gold level sponsors—Ferring Pharmaceuticals and Progyny— and Bronze level sponsor, ARC Fertility.

Fertility Stories by Women in Medicine

Share Your Story

Amato, P. Embryo Donation: One Doctor’s Story. The Egg Whisperer Show. Accessed 11 August 2022.

Marshall, AL. My Infertility Journal as a Woman in Medicine. AM Rounds, 11 March 2020. Accessed 24 April 2020.

Marshall, AL. Ariela Marshall on Physician Infertility. Explore the Space Podcast, 30 January 2020. Accessed 24 April 2020.

Salles A, Jungheim E, Levack M. Fertility and Family Planning. Behind the Knife: The Surgery Podcast, 16 September 2019. Accessed 23 April 2020.

Rogers-Vizean CR. Fertility, Family Planning, and the Physician Life. MedPage Today’s KevinMD.com, 1 March 2019. Accessed 23 April 2020.

Zotos A. More and More Women Turn to Egg Freezing to Pause their Biological Clocks. KMOV4, 8 February 2019. Accessed 23 April 2020.

Parsons M. The Silent Struggle of Female Physician. Feminem.org, 27 February 2019. Accessed 23 April 2020.

Salles A. I Spent My Fertile Years Training to Be a Surgeon. Now, It Might Be Too Late for Me to Have a Baby. TIME, 3 January 2019. Accessed 23 April 2020.

Salles A. “Take advantage of [your] fertility”: One surgeon’s advice to the next generation of female docs. Advisory Board, 16 January 2019. Accessed 23 April 2020.

Corey B. Infertility and the Female Surgeon. AAS, 18 October 2018. Accessed 23 April 2020.

Wijayasinghe S. As a doctor, I helped women trying to conceive. Then I became a patient. The Globe and Mail, 16 May 2017. Accessed 23 April 2020.

Khan FA. The Isolation of Infertility in Female Physicians. DoctorCPR.com, 8 June 2016. Accessed 23 April 2020.

Lockwood K. During a Physician’s Infertility Journey, Another Doctor Offers Hope. MedPage Today’s KevinMD.com, 15 January 2016. Accessed 23 April 2020.

Every voice makes a difference.

AMWA wants to help you amplify your voice. If you would like to share an article on the AMWA blog or write an Op-Ed, please feel free to use AMWA provided templates.

Write an Op-Ed Share Your Story Join the Advocacy Subcommittee

Insurance Coverage by State

Coverage for infertility diagnosis and treatment vary from company to company and from state to state. Listings of state to state information has been compiled by Resolve, the National Infertility Association, the National Conference of State Legislatures, and the American Society of Reproductive Medicine.

RESOLVE holds an annual Federal Advocacy Day and State Advocacy Days to help raise awareness of infertility and advocate for legislation that ensures access to fertility diagnosis and treatment.

Below is a list of states with specific provisions related to coverage of infertility diagnosis or treatment.

Arkansas (ASRM)
California (ASRM)
Connecticut (ASRM)
Delaware (ASRM)
Hawaii (ASRM)
Illinois (ASRM)
Louisiana (ASRM)
Maryland (ASRM)
Massachusetts (ASRM)
Montana (ASRM)
New Hampshire (ASRM)
New Jersey (ASRM)
New York (ASRM)
Ohio (ASRM)
Rhode Island (ASRM)
Texas (ASRM)
Utah (ASRM)
West Virginia (ASRM)

General Insurance Information

Aetna
Cigna
United Healthcare
Blue Cross Blue Shield
Tricare

Publications

Abortion Among Physicians
(Obst & Gyn, April 2022)
Levy, Morgan S. BS; Arora, Vineet M. MD, MAPP; Talib, Hina MD; Jeelani, Roohi MD; Duke, Cindy M. P. MD, PhD; Salles, Arghavan MD, PhD

The Impact of COVID-19 on Family Building Among Physicians and Trainees
(J Gen Int Med, Feb 2022)
Morgan S. Levy, BS; Amelia G. Kelly, MD; Alyssa D. Brown, BS; Alberto Caban-Martinez, DO, PhD; Vineet M. Arora, MD, MAPP; Arghavan Salles, MD, PhD

Improving Family-Building Support and Fertility Care Access
(Acad Med, Sept 2021)
Amelia G. Kelly, Morgan S. Levy, Alyssa D. Brown