Why should fertility treatment be considered essential healthcare?

Highlights

• Infertility is classified as a disease by the WHO and CDC and should be treated with the same seriousness as other medical disorders.
• Poor insurance coverage for fertility care in the United States contributes to the misconception that it is prohibitively expensive compared to other healthcare.
• The stress and grief associated with an infertility diagnosis can be comparable to that of a cancer diagnosis or the loss of a loved one.
• Unlike many developed nations with low birth rates, the United States does not adequately cover fertility treatments like IVF through its healthcare system.
• The ability to have a family is an essential life activity, placing fertility treatments in a category of importance similar to other major surgeries.

Expert Insights

The Medical Classification of Infertility

Leading reproductive endocrinologists assert that fertility treatment constitutes essential healthcare, grounding their argument in the classification of infertility as a disease. "Infertility is defined as a disease by the WHO and the CDC, so it should be covered," states Dr. Molly Moravek. This perspective is echoed by Dr. Randi Goldman, who considers infertility a medical disorder that should be treated like any other. Dr. Goldman acknowledges that while progress toward this recognition is a "slow-moving train," it is imperative that the condition "be part of the conversation" within the medical and insurance communities.

"Having infertility is a medical disorder, and I think it should be treated like any other." Dr. Randi Goldman

The Profound Psychosocial Impact

Beyond the formal diagnosis, the profound emotional toll of infertility warrants its consideration as a serious medical condition. Dr. Serena Chen draws a stark parallel between the patient experience of infertility and other major health crises. She explains that infertility can cause "stress and grief similar to a cancer diagnosis or the loss of a loved one." However, she observes that society often fails to treat this suffering with commensurate seriousness. This discrepancy contributes to a climate of "shame, stigma, and secrecy," which Dr. Chen argues only compounds the pain experienced by patients navigating their diagnosis and treatment options.

"Infertility causes stress and grief similar to a cancer diagnosis or the loss of a loved one." Dr. Serena Chen

Recontextualizing Cost and Coverage

The perception of high cost often serves as a primary barrier to classifying fertility treatment as essential, a misconception largely driven by poor insurance coverage in the United States. Dr. Chen points out that "IVF is very poorly covered in the United States, which differs from most developed nations." She clarifies that this lack of coverage, not an intrinsically exceptional price, fuels the idea that IVF is unusually expensive. "In reality, all healthcare is expensive, and IVF is no more costly than many other standard medical treatments," she states, citing procedures like major surgeries or organ transplants as comparable financial undertakings.

A Fundamental Aspect of Health and Society

The argument for essentiality extends beyond individual patient health to broader humanistic considerations. Dr. Chen frames the ability to have a family as "an essential life activity—closely linked to survival and the continuation of the human race." While not always as immediately life-threatening as some conditions, she contends that "in many ways it carries similar weight." This view is implicitly supported by the policies of many developed nations that cover IVF to address low birth rates—a measure Dr. Chen notes the U.S. has not adopted despite its own low birth rate. The convergence of these factors—infertility's classification as a disease, its severe psychosocial impact, and its fundamental role in human life—underscores the need for parity in care. As Dr. Goldman concludes, progress may be slow, but it is imperative that infertility is treated with the seriousness of any other medical disorder.

"The ability to have a family is an essential life activity—closely linked to survival and the continuation of the human race." Dr. Serena Chen