Infertility Services in Family Planning Care Toolkit
Welcome to the Toolkit
Basic infertility services are a core component of family planning services, the Title X Program, and the Quality Family Planning Recommendations (QFP). Basic infertility services are part of the broader scope of services centered on supporting clients in achieving a healthy pregnancy, and supporting individuals and couples to achieve their reproductive and family building goals.
This toolkit is framed by the core Title X values of quality, access, and equity. Persisting structural barriers (e.g., unaffordable services, racism, inequitable insurance coverage) limit access to infertility services. Racial and socioeconomic disparities exist both in the burden of infertility (i.e., who experiences infertility, treatment outcomes) and in access to services for evaluation and treatment of infertility.1 This toolkit is designed to support family planning programs and staff in delivering quality, accessible, and equitable infertility services. This means: providing that align with nationally recognized standards of care (quality); connecting clients to specialized clinical services and a broad range of resources in support of infertility treatment and care, and reproductive and family building goals (accessible)2; and providing services in a manner that is and (equitable).
This toolkit is intended to help family planning agencies and staff, including Title X providers, understand the scope of basic infertility services, and to strengthen and guide their provision of infertility services and referrals to support clients experiencing infertility.
Use this toolkit as a guide to provide and strengthen infertility services within your family planning practice.
This toolkit recommends the following steps:
- Assess your program’s infertility services
- Train and prepare staff to deliver basic infertility services
- Integrate infertility prevention and education into client care for all
- Provide quality, accessible, equitable, and inclusive infertility services
- Strengthen referrals for additional services and supports for clients with infertility
Conduct a systematic review of your agency’s current infertility services and practices, and identify gaps and opportunities for improvement. Prioritize strategies for quality improvement over time to strengthen infertility services, as well as to provide appropriate referrals for medical, social, emotional, and/or spiritual services to support clients experiencing infertility.
Identify an improvement goal and strategies to enhance infertility services.
Equip family planning staff with a foundational understanding of infertility, including: definitions of infertility and common causes and risk factors; evaluation and treatment for infertility; the emotional burden of infertility and infertility treatment; the prevalence of and disparities in infertility; and barriers, disparities, and inequities in infertility care. Family planning staff should be knowledgeable and skilled in providing inclusive and culturally affirming infertility services that support the family building goals of all clients, including LGBTQ+ clients.
Review with staff common factors associated with and causes of infertility, such as polycystic ovarian syndrome (PCOS), untreated chlamydia and gonorrhea, pelvic inflammatory disease (PID), endometriosis, and thyroid disease; as well as unexplained infertility and iatrogenic, or medically induced, infertility.
Provide staff with ongoing training and support to apply principles of cultural humility and to mitigate the impact of implicit bias in client care.
Family planning providers can support reproductive well-being, fertility, and fertility preservation by focusing on infertility prevention through: screening for and treating conditions that may influence fertility; and providing quality preconception health services.
By understanding each client’s unique circumstances and family building goals, family planning staff can provide appropriate clinical services, non-clinical resources, and referrals to support clients experiencing infertility or clients who are interested in fertility preservation options.
Conduct a medical history, reproductive history, review of systems, physical examination, and laboratory testing, as indicated, and provide counseling and referrals based on information from the clinical evaluation.
Implement a trauma-informed, client-centered approach—guided by the principles of trauma-informed care—when providing infertility services and support.
Counsel clients on additional infertility evaluation, as needed, and on considerations for accessing and utilizing treatment options.
Provide clients with clinical and non-clinical referrals and resources that may go beyond your site’s scope of services. In addition to linking clients to specialist care for medically-based infertility services, family planning agencies can provide clients with information, education, and resources on the social, emotional, financial, and other aspects of navigating infertility and treatment.
Refer clients experiencing infertility or infertility factors for additional assessment, treatment, counseling, and/or social, emotional, or spiritual support services, including LGBTQ+-specific services.
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