Fertility Treatment Disparities Persist Despite Benefits

Coverage alone did not erase unequal starting lines in fertility care, according to a GlobeNewswire release published on October 28. Research presented at the American Society for Reproductive Medicine congress found that fertility treatment disparities persisted even among patients who already had access to fertility benefits. The study examined twelve thousand five hundred sixteen patients who accessed fertility benefits during 2024 and 2025, looking at treatment initiation, time to care, treatment selection and time to pregnancy. The central finding was uneven: getting a benefit card did not mean every group started treatment at the same rate or on the same timetable, according to the release, which was carried by USA Newshour.

The gaps in starting treatment were clear across the groups studied, according to the release. African American and Black patients had treatment initiation rates approximately ten percent lower than White patients, despite access to fertility benefits. Asian and Pacific Islander patients had initiation rates approximately nineteen percent lower than White patients. Patients identifying as Other or Mixed race and ethnicity had initiation rates approximately eleven percent lower than White patients. Those differences show up before any discussion of success rates, because they describe who begins care at all, and they form the core of the fertility treatment disparities described in the new research.

Waiting time added a second layer to the fertility treatment disparities, according to the release. African American and Black patients waited an average of one hundred thirty six days between an initial fertility consultation and treatment initiation. Patients identifying as Other or Mixed race and ethnicity waited an average of one hundred forty four days over the same interval. White patients waited an average of one hundred twenty seven days. The differences amounted to nine extra days for African American and Black patients and seventeen extra days for patients identifying as Other or Mixed race and ethnicity, a delay that matters when treatment plans are tied to age, cycle timing and work schedules.

Where treatment paths diverged

Once treatment began, the picture changed in one important respect, according to the release. The time from an initial consultation to the start of a treatment cycle resulting in pregnancy ranged from one hundred eighty days to one hundred ninety days across racial and ethnic groups, with relatively modest differences between groups. That narrower range suggests the sharpest fertility treatment disparities sit at the front door of care, in the period when patients decide whether to proceed, complete an evaluation or accept a recommended plan, rather than in the later stages after a cycle that resulted in pregnancy has started.

Treatment selection also varied by group, according to the release, and that variation is part of the fertility treatment disparities picture. Asian and Pacific Islander patients had twenty three percent higher adjusted odds of initiating intrauterine insemination and fifteen percent lower adjusted odds of initiating in vitro fertilization compared with White patients. In vitro fertilization generally offers higher success rates per treatment cycle than intrauterine insemination, according to the release, while the most appropriate treatment still depends on each patient and their clinical circumstances. The finding does not by itself show that any patient received the wrong treatment, but it does show that the route into care looked different depending on group.

Janet Choi, chief medical officer at Progyny, said expanding access to fertility benefits is an important step toward making care more equitable, according to the release. Choi also said the research shows coverage alone does not eliminate every barrier that feeds fertility treatment disparities, according to the release. The point she drew from the results was practical: once patients engage in treatment, time to pregnancy looks largely similar across groups, so attention should turn to the barriers that keep some patients from pursuing an evaluation or proceeding to a timely indicated treatment even when comprehensive benefits are available.

Why the gap remains open

The study did not evaluate the underlying reasons for the differences in treatment initiation, according to the release. Clinical indications, patient preferences, decisions to defer treatment and potential barriers to care may all play a role, according to the researchers. That open question matters for how clinics and benefit programs respond to fertility treatment disparities, because each possible explanation points to a different fix. A scheduling bottleneck calls for different changes than a gap in guidance, and a personal decision to wait calls for respect rather than pressure.

Kyle Le, a reproductive endocrinology and infertility fellow at Shady Grove Fertility who presented the research, said improving fertility care requires understanding who reaches treatment in the first place, according to the release. Le said the findings point to closer attention to differences in treatment decisions across patient populations, to opportunities for appropriate personalized care and to closing fertility treatment disparities, according to the release. The research was conducted by investigators affiliated with Shady Grove Fertility, the Icahn School of Medicine at Mount Sinai, Progyny and Reproductive Medicine Associates of New York, according to the release.

For readers following this area, the fertility treatment disparities in the new study sit alongside a wider question about what benefit design can and cannot do. A benefit can remove a bill, but it cannot by itself arrange time off work, explain a diagnosis in plain language, arrange transport to a clinic or answer the questions that make a patient pause after a first consultation. The researchers said further work is needed to understand those differences and to identify opportunities to support informed individualized treatment decisions, according to the release. Until that work lands, the study leaves benefit programs with a clear task: look past the coverage card and examine the steps between a first appointment and a first treatment.

According to earlier GenZNewZ reporting, readers can also read the reproductive health report every Gen Z woman should see, the study of sex frequency and fertility and the campus sexual health vending machine story.