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Hariton E, Alvero R, Hill MJ, Mersereau JE, Perman S, Sable D, Wang F, Adamson GD, Coutifaris C, Craig LB, Hosseinzadeh P, Imudia AN, Johnstone EB, Lathi RB, Lin PC, Marsh EE, Munch M, Richard-Davis G, Roth LW, Schutt AK, Thornton K, Verrilli L, Weinerman RS, Young SL, Devine K. Meeting the demand for fertility services: the present and future of reproductive endocrinology and infertility in the United States. Fertil Steril 2023; 120:755-766. [PMID: 37665313 DOI: 10.1016/j.fertnstert.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023]
Abstract
The field of reproductive endocrinology and infertility (REI) is at a crossroads; there is a mismatch between demand for reproductive endocrinology, infertility and assisted reproductive technology (ART) services, and availability of care. This document's focus is to provide data justifying the critical need for increased provision of fertility services in the United States now and into the future, offer approaches to rectify the developing physician shortage problem, and suggest a framework for the discussion on how to meet that increase in demand. The Society of REI recommend the following: 1. Our field should aggressively explore and implement courses of action to increase the number of qualified, highly trained REI physicians trained annually. We recommend efforts to increase the number of REI fellowships and the size complement of existing fellowships be prioritized where possible. These courses of action include: a. Increase the number of REI fellowship training programs. b. Increase the number of fellows trained at current REI fellowship programs. c. The pros and cons of a 2-year focused clinical fellowship track for fellows interested primarily in ART practice were extensively explored. We do not recommend shortening the REI fellowship to 2 years at this time, because efforts should be focused on increasing the number of fellowship training slots (1a and b). 2. It is recommended that the field aggressively implements courses of action to increase the number of and appropriate usage of non-REI providers to increase clinical efficiency under appropriate board-certified REI physician supervision. 3. Automating processes through technologic improvements can free providers at all levels to practice at the top of their license.
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Affiliation(s)
- Eduardo Hariton
- Reproductive Science Center of the San Franisco Bay Area, San Francisco, California
| | - Ruben Alvero
- Fertility and Reproductive Health, Lucille Packard Children's Hospital, Sunnyvale, California; Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California.
| | - Micah J Hill
- National Institutes of Health, National Institute for Child Health and Human Development, Program in Reproductive and Adult Endocrinology, Bethesda, Maryland
| | | | - Shana Perman
- Shady Grove Fertility, Washington, District of Columbia; Shady Grove Fertility, Columbia, Maryland
| | - David Sable
- Special Situations Life Sciences Fund and Department of Biological Sciences, Columbia University, New York, New York
| | - Fiona Wang
- Lucile Packard Children's Hospital/Stanford Children's Health and Stanford Fertility and Reproductive Health, Sunnyvale, California
| | - Geoffrey David Adamson
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, ACF, Stanford University, Stanford, California
| | - Christos Coutifaris
- Division of Reproductive Endocrinology and Infertility, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - LaTasha B Craig
- Section of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynecology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Pardis Hosseinzadeh
- Section of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, Maryland
| | - Anthony N Imudia
- Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida
| | - Erica B Johnstone
- Division of Reproductive Endocrinology and Infertility, University of Utah, Salt Lake City, Utah
| | - Ruth B Lathi
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
| | - Paul C Lin
- Seattle Reproductive Medicine, Seattle, Washington; Seattle Reproductive Medicine, Bellevue, Washington
| | - Erica E Marsh
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Michele Munch
- Department of Obstetrics and Gynecology, Pennsylvania State University Health, York, Pennsylvania
| | - Gloria Richard-Davis
- Department of Obstetrics and Gynecology, Reproductive Endocrinology and Infertility, University of Arkansas, Little Rock, Arkansas
| | | | - Amy K Schutt
- Texas Fertility Center, Austin, Texas; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
| | - Kim Thornton
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston; Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston; Boston IVF, Waltham, Massachusetts
| | - Lauren Verrilli
- Division of Reproductive Endocrinology and Infertility, University of Utah, Salt Lake City, Utah
| | - Rachel S Weinerman
- Department of Obstetrics and Gynecology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Steven L Young
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina
| | - Kate Devine
- National Institutes of Health, National Institute for Child Health and Human Development, Program in Reproductive and Adult Endocrinology, Bethesda, Maryland; Shady Grove Fertility, Washington, District of Columbia; Departments of Obstetrics and Gynecology, Georgetown University and George Washington University, Washington, DC
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