10/14/2026
PFC Faculty Director I. Glenn Cohen recently co-wrote a perspective in the New England Journal of Medicine (NEJM Group) addressing gaps in the World Health Organization's (WHO) definition of infertility, which inhibits equitable access to fertility care.
The piece, co-authored by Paula Amato, M.D., professor of obstetrics and gynecology and director of Oregon Health & Science University's division of reproductive endocrinology and infertility, argues that the WHO’s definition of fertility as “a disease of the male and female reproductive system defined as the failure to achieve a pregnancy after 12 months of regular unprotected sexual in*******se,” effectively excludes LGBTQ+ people and single people without eggs or s***m who also face fertility challenges.
The authors suggest that the definition should be more expansive and cover the need for medical intervention to achieve a successful pregnancy for LGBTQ+ and single people.
Because eligibility requirements for coverage of fertility care in the United States still often disadvantage LGBTQ+ and single people, there has been growing legal and policy pressure to eliminate discriminatory definitions of infertility. Of insurance plans that cover fertility treatments, many continue to define infertility as the inability to conceive after 6 to 12 months of unprotected heterosexual in*******se. As a result, LGBTQ+ and single people must often pay thousands of dollars out of pocket for multiple donor-insemination cycles before becoming eligible for insurance coverage, whereas infertile people in heterosexual relationships can qualify for coverage immediately.
Read the article here: https://www.nejm.org/doi/full/10.1056/NEJMp2603604