All of us come to a crossroads in our lives when we make the decision to have or forgo children. And whether you decide to carry your child or adopt, what's important is that you have access to resources to make the best decision -- or one at all. A new study reveals that 25 million women don't have adequate access to infertility clinics that could very well determine whether or not getting pregnant becomes a reality or remains a dream.
The University of Pittsburgh study, published in the journal Fertility & Sterility, outlines areas across the country lacking in infertility facilities that use assisted reproductive technology (ART). While basic care and evaluation relating to infertility can occur in practices with ob-gyns, the need for specialized procedures -- like in-vitro fertilization (IVF), for example -- would require treatment at an ART center, which is why experts are reiterating the need for better access.
And with an estimated 10 percent of US women (ages 15 through 44) struggling with fertility issues, this is a big problem.
Researchers associated with the study analyzed data from the Centers for Disease Control and Prevention (CDC) to determine there were 510 known ART facilities across the country between 2009 and 2013. Comparing this data to figures from the 2010 US Census, experts were able to identify how many reproductive-age women (ages 20 to 49) have geographical access to infertility centers.
Though 31.8 million women in the US live in an area with multiple infertility clinics, 18.2 million reside in an area with no ART facilities whatsoever, and another 6.8 million live in towns and cities with only one facility -- representing the 25 million women who have inadequate access to specialized infertility care.
Map of United States by regional access to ART
Fertility & Sterility journal
As you can see from the study's map, a woman would likely have to travel -- sometimes great distance, depending on the state -- in order to receive treatment at an ART clinic. Wyoming and Maine, for example, do not seem to have any facilities in their respective states that specialize in infertility care, while residents of Hawaii would have to travel to the Kauai island for their procedures.
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More research is need to asses women's willingness to travel to an infertility facility, as well as other factors (such as age, and racial and socioeconomic disparities) that likely play a part in accessing treatment -- but there is general consensus that ART centers are geographically lacking in a way that can prevent pregnant hopefuls from being able to make the best choice (or one at all) for their families.
Because, as the study notes, ART centers are commonly found in areas with mandated insurance coverage for infertility treatments and places that boast the highest per capita income, which really isn't a surprise but doesn't automatically make it right.
As Dr. John Harris, coauthor of the study and assistant professor at University of Pittsburgh's School of Medicine and Magee-Womens Hospital of UPMC, so aptly noted in response to these findings, "Infertility is by itself a difficult issue for couples to face emotionally and financially."
He continued, "Based on geography, many couples who are trying to start families may have only one clinic nearby where they seek these services, and many women with infertility do not have any nearby access to these services at all, adding additional anxiety during an already stressful time of life."
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Looking back at both of my pregnancies, I'm so thankful how smoothly things went. Not only was I able to carry both of my boys to term and have a somewhat "pleasant" experience in the natural childbirth arena, but I also had access -- the choice to pick ob-gyns whose principles and way of doing things matched what I believed.
I can't imagine not having that choice -- or having to shell out a small fortune (on top of the average costs of infertility-related treatments) in travel -- just to have the family I have today, because I may or may not live in an area where the powers that be assume I can or can't afford the costs.
Honestly, I'm just not sure I would have a fighting chance if put in the position.
Women (and men) who struggle from infertility shouldn't carry the burden of lack of access to resources (and options) in addition to their struggle to conceive.