Fertility and Infertility Services in Family Planning Care Toolkit: Supporting Clients to Achieve Pregnancy
Welcome to the Toolkit
Family planning includes a broad range of services related to achieving pregnancy, preventing unintended pregnancy, and assisting clients in reaching their desired number and spacing of children. Family planning site managers and clinical providers can use the information and resources in this toolkit in any order to support clients who desire pregnancy, including clients who are at risk for or experiencing infertility. Infertility affects nearly one in eight couples and can be devastating, causing clients emotional distress and feelings of shame, grief, and loss. As family planning sites,Title X programs are well-positioned to support clients in achieving their family building goals.
Staff providing reproductive health services should regularly assess the extent to which their agency supports clients with a wide range of goals related to fertility. Title X services must be provided without subjecting individuals to any coercion to accept services or to employ or not to employ any particular methods of family planning. Providing family planning services in a client-centered manner is a core tenet of the Title X Program.
Ensure staff are trained on:
- What constitutes a normal menstrual cycle
- Menstrual cycle abnormalities that may indicate reproductive or systemic health issues
Ensure staff are trained on:
- Fertility indicators
- How to use fertility awareness-based methods (FABMs) for achieving and preventing pregnancy
Provide client-centered counseling on the menstrual cycle, fertility indicators, FABMs, as well as technology-enabled solutions to help clients monitor fertility indicators.
Ensure quality client education related to menstrual health and fertility indicators by:
- Maintaining policies and procedures
- Assessing opportunities for improvement
Strengthening Integrated Approaches for Family Planning and Menstrual Health (Hoppes et al.)
Ensure staff are trained to recognize and respond to common root causes of female infertility, including:
- Hormonal imbalance (e.g., PCOS)
- Untreated medical conditions (e.g., hypertension or STIs, such as chlamydia)
- Blocked fallopian tubes (e.g., from Pelvic Inflammatory Disease, or PID)
- Endometriosis
Integrating Hypertension Prevention and Control into Family Planning Services eLearning
Ensure staff are trained to recognize and respond to common root causes of male infertility, including:
- Environmental factors (e.g., medications)
- Medical conditions (e.g., diabetes, hypertension)
- Genetic conditions
- Sperm production issues
- Varicocele
Screen all clients for health conditions and modifiable lifestyle factors that may impact overall health as well as fertility, regardless of pregnancy intention.
Provide client-centered counseling on health conditions and modifiable lifestyle factors that impact overall health as well as fertility.
Insulin Resistance and Prediabetes: Why NOW is the Time to Intervene Job Aid
Provide client-centered counseling on environmental or toxin exposures which may impact health and fertility.
Understanding Endocrine Disruptors and Fertility Video
Refer clients for further evaluation or medical treatment options to address health conditions that cannot be addressed by your agency.
Establishing and Providing Effective Referrals for Clients: A Toolkit for Family Planning Providers
Ensure quality preventive health services for all clients by:
- Maintaining policies and procedures
- Assessing opportunities for improvement
Ensure staff are trained on how to counsel and support clients who seek pregnancy to:
- Maximize their fertility
- Prepare for a healthy pregnancy by optimizing health prior to pregnancy (“preconception health”)
Provide client-centered counseling on strategies for achieving a healthy pregnancy.
Ensure quality services for clients seeking pregnancy by:
- Maintaining policies and procedures
- Assessing opportunities for improvement
Ensure staff are trained on:
- Foundational concepts of infertility and infertility services
- Infertility evaluation and treatment options
- Emotional support for clients experiencing infertility
Conduct a clinical evaluation of infertility, including medical history, reproductive history, review of systems, physical examination, and laboratory testing, as indicated.
Provide client-centered counseling, education, and treatment, in response to the findings from the clinical evaluation.
A Case Study: Providing Basic Infertility Services in a Title X Setting (CTC-SRH)
Refer clients for further evaluation or medical treatment options to address health conditions that cannot be addressed by your agency.
Establishing and Providing Effective Referrals for Clients: A Toolkit for Family Planning Providers
Connect to the Office of Population Affairs’ Embryo Adoption Awareness and Services Program, which increases public awareness of embryo donation/adoption.
Embryo Adoption Awareness and Services Program (OPA)
Ensure quality infertility services by:
- Maintaining policies and procedures
- Assessing opportunities for improvement
- Ensuring referrals for more in-depth infertility services are available, including consideration of access for low-income clients
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