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Thirty years ago family planning was synonymous with using contraception and the prevention of pregnancy. Today, that definition has changed immensely to recognize the importance of helping couples achieve pregnancy. In general, infertility is defined as not being able to get pregnant (conceive) after one year of unprotected sex (6 months for women 35 or older). In the United States, infertility is widespread and affects about 6% of married women 15–44 years of age. An additional 12% of women ages 15-44 suffer from impaired ability to get pregnant or carry a pregnancy to a live birth, a condition referred to as impaired fecundity. While it is often thought of as just a women’s condition, both men and women contribute to infertility, with 9% of U.S. men reporting male-related infertility.  For couples experiencing difficulty conceiving, the effects of infertility can be devastating.

Infertility also has important public health implications. Given that many treatments result in twin and higher order births, both mothers and infants are at increased risk for adverse health outcomes.  Additionally, many known causes of infertility, such as sexually transmitted diseases, environmental exposures, obesity, and smoking, are well-known public health threats. While there is increasing recognition of how these factors affect fertility, there are still many opportunities to better understand and address population level issues that contribute to infertility in men and women.

In this fascinating session of Grand Rounds we delved into strategies associated with the detection, prevention, and management of infertility. This session also addressed clinical approaches to improving the safety and efficacy of infertility treatments in an effort to promote healthy pregnancy outcomes.

Beyond the Data

Dr. Phoebe Thorpe and Dr. Lee Warner discuss infertility as a public health issue.

Individuals should know that:

  • Infertility is personally devastating and results in several quality of life challenges
  • It is a disease that affects both men and women
  • There are organizations that provide support – RESOLVE: The National Infertility Association and The American Fertility Association

Providers must:

  • Focus on preconception care, including encouraging patients to stop smoking and weight management
  • Preserve fertility of individuals being treated with chemotherapy, especially adolescents

Public health can:

  • Continue efforts to reduce preventable risk factors such as sexually transmitted diseases, obesity and smoking
  • Improve surveillance to identify and address racial and geographic disparities in both risk factors and access to treatment

Presented By

Lee Warner, PhD, MPH
Associate Director for Science, Division of Reproductive Health
National Center for Chronic Disease Prevention and Health Promotion, CDC
Eli Y. Adashi, MD, MS, CPE, FACOG
Professor of Medical Science, Division of Biology and Medicine, The Warren Alpert Medical School
Brown University
Barbara Collura, MA
President and CEO
RESOLVE: The National Infertility Association
Dmitry Kissin, MD, MPH
Team Lead, Assisted Reproductive Technology Surveillance and Research Team, Division of Reproductive Health
National Center for Chronic Disease Prevention and Health Promotion, CDC

Facilitated By

John Iskander, MD, MPH
Scientific Director
Phoebe Thorpe, MD, MPH
Deputy Scientific Director
Susan Laird, MSN, RN
Communications Director

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  • Page last reviewed: February 28, 2018
  • Page last updated: February 28, 2018
  • Content source:
    • Office of the Associate Director for Science
    • Page maintained by: Office of the Associate Director for Communication
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