Meeting the demand for fertility services: the present and future of reproductive endocrinology and infertility in the United States

The field of reproductive endocrinology and infertility (REI) is at a crossroads; there is a mismatch between demand for reproductive endocrinology, infertility and assisted reproductive technology (ART) services, and availability of care. This document's focus is to pro -vide data justifying the critical need for increased provision of fertility services in the United States now and into the future, offer ap-proaches to rectify the developing physician shortage problem, and suggest a framework for the discussion on how to meet that increase in demand. The Society of REI recommend the following: 1. Our field should aggressively explore and implement courses of action to increase the number of qualified, highly trained REI phy-sicians trained annually. We recommend efforts to increase the number of REI fellowships and the size complement of existing fellow-ships be prioritized where possible. These courses of action include: a. Increase the number of REI fellowship training programs. b. Increase the number of fellows trained at current REI fellowship programs. c. The pros and cons of a 2-year focused clinical fellowship track for fellows interested primarily in ART practice were extensively explored. We do not recommend shortening the REI fellowship to 2 years at this time, because efforts should be focused on increasing the number of fellowship training slots (1a and b). 2. It is recommended that the field aggressively implements courses of action to increase the number of and appropriate usage of non-REI providers to increase clinical efficiency under appropriate board-certified REI physician supervision. 3. Automating processes through technologic improvements can free providers at all levels to practice at the top of their license. (Fertil Sterile 2023;120:755-66. (c) 2023 by American Society for Reproductive Medicine.) El resumen esta disponible en Espanol al final del articulo.

Automated summary

The field of reproductive endocrinology and infertility faces a mismatch between demand and availability of care. It is recommended to increase the number of qualified physicians and non-REI providers to address the physician shortage problem and improve clinical efficiency through technological improvements.