title: Access to assisted reproductive technology centers in the United States.
abstract: OBJECTIVE
  To describe the disparity of assisted reproductive technology (ART) centers in the United States as they relate to residential locations of populations in their reproductive years and state-mandated coverage for infertility services.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Population in reproductive years (women 20-44 years; men 20-49 years) based on US Census 2000 data. Assisted reproductive technology centers registered with the Society for Assisted Reproductive Technology (SART) in 2005.
  
  
  METHODS
  Populations within service area served by in-state and neighboring state ART centers as defined by a 60-minute travel time along road networks from each center.
  
  
  RESULTS
  Service areas for 387 of 390 ART centers were calculated. Fourteen states had some form of mandated coverage. Underserved states included Alaska, Montana, Wyoming, and West Virginia. The northeastern United States had the greatest percentage of overserved population with 66%-100% study population within 60 minutes of an ART center. Female age stratification showed the highest age group (35-44 years) per state in northern New England and the youngest in Utah and District of Columbia. Median total study population within 60 minutes of an ART center in their own state was higher in mandated versus nonmandated states.
  
  
  CONCLUSIONS
  Disparity of access to care for infertility services exists from the standpoint of population service areas for ART centers and state-mandated coverage. Female age stratification may help anticipate future need for services with existing resource distribution.
authors.affiliation: Section of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA. anangia@kumc.edu
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Nangia
authors.forename: Donald S
authors.initials: DS
authors.lastname: Likosky
authors.forename: Dongmei
authors.initials: D
authors.lastname: Wang
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D040362:Geographic Information Systems; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D007246:Infertility / Q000453:epidemiology* / Q000628:therapy*; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D037141:Mandatory Programs / Q000706:statistics & numerical data; D008875:Middle Aged; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data*; D014195:Travel / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult