Infertility Awareness Week April 18-24

Infertility affects 1:4 women physicians

American Medical Women’s Association

 Physician Fertility Initiative

“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. Our profession should not stand in the way.”

— Dr. Ariela Marshall, Dr. Vineet Arora, and Dr. Arghavan Salles
 

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    The Need 

    • 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 impacts 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.

    Opportunities

     

     

    Sources:

    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.

    Physicians and Infertility

     — Dr. Ariela Marshall, Dr. Vineet Arora, and Dr. Arghavan Salles. Academic Medicine, 2019.

    Compound that with the fact that the peak years for childbearing often collide with the most grueling years of medical training. It’s no wonder then that women physicians face higher infertility rates than the general population. 

     

    By compiling a list of resources, publications, and stories, AMWA hopes to raise awareness of physician infertility, streamline advocacy efforts, and provide support for women in medicine.

     

     

    Learn about the Physician Fertility Summit hosted by AMWA 2021.

     

    Learn about the Physician Fertility Summit

     

    Join Our Efforts     Share Your Story

     

    Articles

    Marshall AL, Arora VM, Salles A. Physician Fertility: A Call to Action. Acad Med. 2020;95(5):679-681.

    Stentz NC, Griffith KA, Perkins E, Jones RD, Jagsi R. Fertility and Childbearing Among American Female Physicians. J Womens Health (Larchmt). 2016 Oct;25(10):1059-1065. Epub 2016 Jun 27. 

    Scully R, Melnitchouk N, Davids JS. Fertility and Pregnancy Outcomes in Female Physicians in Procedural Specialties: A Large National Survey. Journal of the American College of Surgeons. October 2016; 223 (4) Supp 1: S109. 

    Aghajanova L, Hoffman J, Mok-Lin E, Herndon CN. Obstetrics and Gynecology Residency and Fertility Needs. Reproductive Needs. 2017 Mar;24(3):428-434. Epub 2016 Sep 27.

    Gyorffy Z, Dweik D, Girasek E. Reproductive Health and Burn-out Among Female Physicians: Nationwide, representative study from Hungary. BMC Women’s Health. 2014 Oct; 14(121):1-12.

    Clarka NA, Griffith K, Perkins E, Jagsi R. Experiences with Fertility and Infertility Among Generation X Physicians. American Society for Reproductive Medicine. September 2013;100 (3)Supp: S317.

    Kemkes-Grottenthaler A. Postponing or Rejecting Parenthood? Results of a Survey Among Female Academic Professionals. Journal of Biosocial Science. 2003; 35(2), 213–226. 

     

    Testimonials

    “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. While the journey is heartbreaking, I do now have the self-awareness to realize that no matter the outcome, my infertility is separate from my value as a woman and a human being. I will not sugar coat the fact that my “failure” as a potential mother has taken and continues to take a huge physical and emotional toll on myself and as well as my incredibly supportive husband. However, I have at least realized that I have worth as a human being no matter what my eggs do or do not create in the future. Dealing with failure gives us the tools to acknowledge our own self-worth.”     

    — Ariela L. Marshall, MD (AM Rounds)

    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. 

    Share Your Story

     

    Education

    CDC Infertility FAQs

    Infertility Work-up for the Women’s Health Specialist (ACOG)

    Infertility (ASRM)

    Grand Rounds Recorded Webinar: Female Infertility (free CME)

     

    Advocacy

    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.

     

     

    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.

    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

    Funding Resources

    Infertility Treatment Grants and Scholarships (from Resolve, the National Infertility Association)
    Infertility Treatment Grants (from Fertility Within Reach)

    COVID-19 Resources

    Statements

    Patient Management and Clinical Recommendations During The Coronavirus (COVID-19) Pandemic (ASRM)

    ASRM Infographics:

    COVID-19 and Human Reproduction Joint Statement: ASRM/ESHRE/IFFS

    COVID-19 in Pregnancy (SOGC)

    Laboratory Guidance For Commencing Or Continuing ART Operations During The Ongoing COVID-19 Pandemic (SART)

    Webinars

    Male Reproductive Health, Science and Laboratory Issues During the COVID-19 Era (ASRM) – June 2nd, 6:00pm CT. Register HERE.

    Emergency Fertility Preservation in the COVID-19 Era (ASRM)

    Reproductive Health in Emergency Preparedness & Response (CDC)

    Journal Articles

    Recommendations for development of an emergency plan for in vitro fertilization programs: a committee opinion (Fertility & Sterility)

    The perspective of Italian embryologists managing the IVF laboratory in pandemic emergency (Human Reproduction)

    News Articles

    Coronavirus, pregnancy, and in vitro fertilisation (The Telegraph)

    Pregnancy & Reproductive Health

    Universal Screening for SARS-CoV-2 in Women Admitted for Delivery (NEJM)

    Should Infants Be Separated from COVID-19 Positive Mothers? (JWH)

    Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records (Lancet)

    What are the risks of COVID-19 infection in pregnant women? (Lancet)

    Potential Maternal and Infant Outcomes from Coronavirus 2019-nCoV (SARS-CoV-2) Infecting Pregnant Women: Lessons from SARS, MERS, and Other Human Coronavirus Infections (MDPI)

    Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know (American Journal of Obstetrics and Gynecology) — Journal pre-proof

    Resources for Maternal Health from the Maternal Mental Health Leadership Alliance

    Novel Coronavirus “COVID-19”: Special Considerations for Pregnant Women (Kaiser Family Foundation)

    COVID-19: A Gender Lens. Protecting sexual and reproductive health and rights, and promoting gender equality (United Nations Population Fund)

    Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know (American Journal of Obstetrics and Gynecology) — Journal pre-proof

    AMWA has adopted the article Physician Infertility: A Call to Action as its official position paper. Below are some of the key points in that article where AMWA intends to work:

    1. Increase education and awareness about fertility.
    2. Advocate for insurance coverage for and access to fertility assessment and management.
    3. Improve insurance coverage for physicians or physicians in training for fertility treatments.
    4. Support trainees and physicians undergoing fertility treatments through psychological support, flexible work policies.
    5. Ensure family/parental health leave for physicians who must be absent for fertility treatments.
    6. Ask accreditation bodies and professional societies to consider all aspects of parental health—including fertility management—when evaluating institutional approaches to trainee and faculty well-being.
    7. Increase awareness on the part of institutional leaders to improve empathy and understanding and promote creation of innovative programs for fertility support for medical students, residents, fellows, and practicing physicians.

     

    Events

    AMWA is hosting the first ever Physician Fertility Summit. Learn more and register HERE.