title: Limitations and barriers in access to care for male factor infertility.
abstract: The primary challenge to identifying and addressing barriers in access to care for male factor infertility is accurate measurement of the prevalence of male infertility. Current estimates are based on couples pursuing assisted reproduction, and likely underestimate the problem. These estimates also fail to account for the number of patients facing infertility due to cancer or cancer treatment. Lack of health insurance coverage for the diagnosis and treatment of infertility presents a major barrier for couples struggling with infertility. However, it is not the only barrier. Education level, household income, cultural norms, religious beliefs, geographic location, and the availability of specialty-trained reproductive urologists are all important factors in determining the ease with which patients access and obtain infertility care. Addressing each of these obstacles directly is imperative to improving reproductive care and outcomes for infertile couples in the United States.
authors.affiliation: Department of Urology, Emory University School of Medicine, Atlanta, Georgia. Electronic address: akanksha.mehta@emory.edu.
authors.forename: Akanksha
authors.initials: A
authors.lastname: Mehta
authors.affiliation: Department of Urology, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Nangia
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
authors.forename: James M
authors.initials: JM
authors.lastname: Dupree
authors.affiliation: Department of Urology, University of California San Francisco, San Francisco, California; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California.
authors.forename: James F
authors.initials: JF
authors.lastname: Smith
mesh_terms: D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007248:Infertility, Male / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D008297:Male; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
keywords: Assisted reproductive technology; barriers to care; health services accessibility; male infertility; male reproductive health