Infertility Gets New ‘Inclusive’ Definition By Medical Board

A pregnant woman holds her stomach on June 7, 2006. Ian Waldie/Getty Images

American Society for Reproductive Medicine (ASRM) has expanded the definition of infertility from the earlier focus on opposite-sex couples towards a more “inclusive” interpretation including all persons “regardless of marital status, sexual orientation, or gender identity.”

In 2019, ASRM defined infertility generally as the “failure to achieve pregnancy within 12 months of unprotected intercourse or therapeutic donor insemination in women younger than 35 years or within 6 months in women older than 35 years.” There are tests suggested for the infertile female partner that focus on ovarian reserve, ovulatory function, and structural abnormalities, while for the male partner, tests are conducted regarding the individual’s medical history and semen analysis.

ASRM announced on Oct. 15 that the new definition of infertility does not restrict its range to a man-woman relationship, and related treatments must be available to anyone “regardless of relationship status or sexual orientation.” The organization stressed that it has “a longstanding tradition of data-driven, clinically sound positions” and is responding to the needs of a  “diverse patient population” with “different treatment needs.”

“This revised definition reflects that all persons, regardless of marital status, sexual orientation, or gender identity, deserve equal access to reproductive medicine. This inclusive definition helps ensure that anyone seeking to build a family has equitable access to infertility treatment and care,” said Jared Robins, MD, ASRM CEO.

“I thank the Practice Committee, our Board, and other ASRM leaders and staff for diligently and deliberately establishing a definition of infertility that acknowledges the reality of all seeking infertility care. We look forward to working with our members, policymakers, and others to normalize this definition.”

In an Oct. 19 X post, Rep. Gerry Connolly (D-Va.) said he was “thrilled” about the new definition as it includes LGBTQ+ couples.

The U.S. Centers for Disease Control and Prevention (CDC) continues to define infertility as “not being able to get pregnant” after one or more years of unprotected sex while associating it strictly with men and women instead of other gender identities.

The CDC lists the causes of infertility in men as due to various factors like “disruption of testicular or ejaculatory function, hormonal, and genetic disorders.” Among women, infertility is caused by any conditions that affect organs like “ovaries, fallopian tubes, and a uterus.”

In a Fact Sheet published in April, the World Health Organization (WHO) defined infertility as “a disease of the male or female reproductive system.”

Erasing Male/Female Gender Identity

ASRM’s new LGBT “inclusive” definition of infertility is part of a broader attempt to break down the binary male/female categories in all spheres of American life.

For instance, in April last year, the supervisors of San Diego County voted in favor of creating an ordinance that defined the word “women” to include biological males identifying as females.

“In this ordinance, it’s very clear that women and girls refer to those who identify as women and girls, including transgender women, gender non-conforming, and those assigned female at birth, who include non-binary, transgender men, and intersex communities,” Supervisor Nora Vargas said at the time.

Transgender affirming childrens books in irvine, Calif., on Aug. 30, 2022. John Fredricks/The Epoch Times

Earlier in 2021, the then-House Speaker Nancy Pelosi (D-Calif.) and Rules Committee Chairman James McGovern (D-Mass.) announced a proposal to use “gender-inclusive language” in the House, aimed at eliminating gendered words like “‘father, mother, son, [and] daughter.”

In March this year, an undercover video from Project Veritas showed teachers and administrators in New York allegedly conspiring to erase gender divisions. During a meeting with teachers, an LGBT activist suggested “breaking down the gender binary, getting rid of girls and boys.”

Late last month, the American Anthropological Association (AAA) and the Canadian Anthropology Society (CASCA) canceled a scheduled talk that discussed the importance of biological sex in anthropology.

The two groups insisted that the session’s ideas were “advanced in such a way as to cause harm to members represented by the Trans and LGBTQI of the anthropological community.”

Some states are taking steps to legally define gender on the basis of biological sex. In April, Kansas became the first state to adopt such a definition.

According to S.B. 18, a female is defined as “an individual whose biological reproductive system is developed to produce ova.” Meanwhile, a male is defined as “an individual whose biological reproductive system is developed to fertilize the ova of a female.”

The bill also defined “mother” as a parent of the female sex, with “father” being a parent of the male sex.

Insurance Impact

The latest infertility definition by ASRM could have a major impact on the insurance industry. Insurers may now expand coverage of fertility treatments like in vitro fertilization and egg freezing to LGBT individuals as well.

“There’s been a real issue with getting access to treatment for certain causes of infertility including for single people [and] people in same-sex relationships … so it became clear that we need to explicitly address that,” ASRM spokesperson Sean Tipton said in an interview with Axios.

The new definition was heralded as a “game changer” by infertility specialist Lucky Sekhon. Due to the new definition, “insurance companies can’t discriminate … It gives people ammunition to fight policies for more coverage,” she told the outlet.

At present, 21 American states and the District of Columbia require insurers to provide some form of fertility coverage in workplace health plans. Only eight states have policies that include single parents and LGBTQ+ individuals, said Betsy Campbell, chief engagement officer at infertility advocacy group Resolve.

It is not clear what implications the new definition will have for insurance rates, and how the expanded coverage will impact American households.