In October 2023, the American Society for Reproductive Medicine expanded the definition of infertility to include LGBTQ+ couples and single individuals:
‘Infertility’’ is a disease, condition, or status characterized by any of the following:
The inability to achieve a successful pregnancy based on a patient’s medical, sexual, and reproductive history, age, physical findings, diagnostic testing, or any combination of those factors.
The need for medical intervention, including, but not limited to, the use of donor gametes or donor embryos in order to achieve a successful pregnancy either as an individual or with a partner.
In patients having regular, unprotected intercourse and without any known etiology for either partner suggestive of impaired reproductive ability, evaluation should be initiated at 12 months when the female partner is under 35 years of age and at 6 months when the female partner is 35 years of age or older.
Nothing in this definition shall be used to deny or delay treatment to any individual, regardless of relationship status or sexual orientation.
Why Does the Definition of Infertility Matter?
Traditionally defined by the inability to achieve pregnancy after 12 months of regular, unprotected sexual intercourse, same-sex couples and LGBTQ+ individuals seeking reproductive treatment were not factored into the construct of the previous definition of infertility. Failing to consider the reproductive needs of the LGBTQ+ community, resulted in insurance providers denying coverage for LGBTQ+ individuals seeking fertility treatments but failing to meet the defintiion of infertility, among other discriminatory implications.
The ASRM's new definition of infertility specifically includes the use of donor gametes, which is often a part of the path to parentage for LGBTQ+ couples and single individuals.
The specific language of the new definition matters. It matters because not only does it include the LGBTQ+ community as part of the conversation around reproductive care, but it also requires insurance providers to extend the same coverage to he LGBTQ+ individuals as they do to cis-gender heterosexual couples requiring fertility treatment.
In my personal practice just this month we won an insurance appeal for a same-sex female couple denying them IVF coverage for failing to be meet the [old] definition of infertility. This is only the beginning.
The Ripple Effect
The new definition of infertility isn't just a change in terminolgy. This expanded definition of infertility represents a change in the discussions surrounding reproductive care and reproductive rights. This change in language shifts the public's perception regarding access to reproductive care, and questions discriminatory practices inside and outside medical offices. This change in language is the start to new, more inclusive legislation supporting LGBTQ+ families at state and federal levels in the United States.