Fact Sheet: Infertility and IVF Access in the United States: A Human Rights Based Policy Approach

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Infertility

Infertility and IVF Access in the United States: A Human Rights-Based Policy Approach

published by Centre of Reproductive Justice

Infertility impacts millions of people in the United States. Nevertheless, limited information,
restrictive laws and policies, stigma, high cost, and other barriers put infertility care, including in vitro fertilization (IVF), out of reach for many, especially people from marginalized communities. Well-documented disparities in access to infertility care reveal that people of color, low income people, people with disabilities, and LGBTQ communities receive treatment at disproportionately low rates.
Laws and policies that protect and promote equitable access to infertility care help to ensure the full spectrum of reproductive rights, including the right to make decisions about one’s reproductive life, to health, and to equality and non-discrimination. This fact sheet presents the global and U.S. incidence of infertility and explores access gaps and barriers to infertility care in the United States. It also outlines human rights-based policy recommendations to address disparities in access to infertility care, including IVF, particularly among communities most impacted.

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Definitions

Infertility
Definitions of infertility generally refer narrowly to clinical infertility. The Centers for Disease Control and Prevention (CDC), for example, defines infertility as the inability to become pregnant after six months or one year of unprotected sexual intercourse. This definition, often incorporated into legislation to establish or expand IVF insurance coverage, fails to address social infertility, defined as the inability to reproduce via sexual intercourse due to social factors such as a person’s lack of a partner or because of a person’s sexual orientation. The World Health Organization (WHO) distinguishes between primary infertility, which refers to women who have not previously had a pregnancy and live birth, and secondary infertility, which refers to women who have already had at least one pregnancy and live birth. Based on
WHO’s estimates, secondary infertility impacts more women globally than does primary infertility. For the purposes of this fact sheet, infertility refers to both primary and secondary infertility.

Intrauterine Insemination (IUI)
Also known as artificial insemination, IUI is a method of assisted reproduction whereby sperm is transferred directly into a person’s uterus to facilitate fertilization.

In vitro Fertilization (IVF)
IVF is an assisted reproductive technology wherein sperm and eggs are combined in a laboratory to create an embryo that can then be transferred into a uterus, where it may implant in the uterine lining.

Ovulation Induction
Ovulation induction is a medical treatment that uses hormone medication to stimulate the ovaries to produce multiple mature follicles and ova. It can be used in combination with IUI to increase the likelihood of pregnancy.

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General Information: