ASRM Redefines Infertility, Adding Sexual Orientation, Relationships

In an attempt to develop a more inclusive and comprehensive definition of infertility, the American Society for Reproductive Medicine (ASRM) has modified the description to include people unable to conceive due to relationship status or sexual orientation.

“It is our hope that this definition removes one of the excuses that insurance companies have attempted to use to deny patients coverage for the medical care they need to have children,” Sean Tipton, ASRM’s chief advocacy and policy officer, told CNN.

According to the new definition, infertility is when a person cannot have a successful pregnancy due to medical, sexual, or reproductive history. For example, a history of substance use, such as excessive alcohol or tobacco consumption, can alter fertility.

Other factors that can classify a patient as infertile are age, physical findings, or diagnostic testing. Any combination of those factors may also contribute to infertility.

Another element that could help providers characterize a patient as infertile is the need for medical interventions to attain a successful pregnancy. These procedures may include in vitro fertilization, donor embryo use, and more — either with or without a partner.

Finally, the new definition notes that anyone under 35 who has regular, unprotected sex but is not getting pregnant should be evaluated for infertility after one year. Those over 35 should undergo testing after six months.

However, the definition clarifies that no one should use the updated interpretation to deny or delay treatment based on relationship status or sexual orientation.

“This revised definition reflects that all persons, regardless of marital status, sexual orientation, or gender identity, deserve equal access to reproductive medicine. This inclusive definition helps ensure that anyone seeking to build a family has equitable access to infertility treatment and care,” said Jared Robins, MD, ASRM CEO, in the ASRM press release.  

Considering the exorbitant costs of most infertility treatments, the new definition may widen the number of patients able to access reproductive medicine. Although the changes remain to be seen, these updates may improve reproductive health equity.