After examining data from the Centers for Disease Control and
Prevention (CDC), researchers found fertility centers are mainly
located in heavily populated areas in the U.S.
"About 40 percent of women between age 20 and 50 are living in areas
where there are either limited or no options for them," said Dr.
John Harris, of the University of Pittsburgh's School of Medicine
and Magee-Womens Hospital of UPMC.
Harris and his colleagues write in Fertility and Sterility that lack
of geographic access to assisted reproductive technology (ART) is
common and a significant obstacle for patients with infertility.
Using census data and information from the CDC, the researchers
evaluated geographic access to ART clinics in the U.S. - where, they
say, an estimated 7.5 million women face difficulty in having
They identified a total of 510 ART clinics in 144 census areas,
which are geographic regions drawn by similarities to nearby urban
Overall, clinics tended to cluster near population centers like
Boston, Los Angeles, New York and Philadelphia. About 60 percent of
women ages 20 to 49 lived in areas with multiple ART clinics.
About 29 percent lived in areas with no clinics, however. Another 11
percent of women in that age group lived in areas with only one
clinic, which means they didn't have a choice of providers.
In addition to geographic obstacles, cost is also a significant
burden since people often pay for fertility treatments out of
pocket, Harris said.
Long distances to ART clinics means more costs for travel, lodging
and days off work.
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"There is already a significant cost burden," he said. "Whenever you
increase the cost, that only increases the barriers."
The expenses can add up, because in vitro fertilization may require
several repeat visits to ART clinics over a short period, according
to Dr. Kara Goldman, a reproductive endocrinologist and assistant
professor at NYU Langone Medical Centerís Fertility Center in New
"This helps to demonstrate the geographic barriers are significant
for patients," said Goldman, who wasn't involved in the new study.
"This is something we have to address in our field."
Harris said large medical centers can help by operating satellite
ART clinics. Business and employers can also help by allowing people
additional time off for fertility treatments.
SOURCE: http://bit.ly/2mPrg6W Fertility and Sterility, online March
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