In 2007, the CDC formed a working group to coordinate public health-related infertility activities, and identified opportunities for improvement in public health activities to understand and address preventable causes of infertility. The group subsequently published a white paper in 2008 on infertility prevention, detection and management, which included a call for the development of a national plan of action to address infertility issues.
A CDC representative from the Women’s Health and Fertility Branch of the agency’s Division of Reproductive Health has now informed us that the resulting outline for an action plan – “Outline for a National Action Plan for the Prevention, Detection, and Management of Infertility” [PDF] – can now be circulated. Our Bodies Ourselves is one of many organizations engaged in the review of the document, alongside other professional, advocacy, consumer health, and educational organizations and institutions.
As the background section explains, some infertility may be preventable through public health approaches:
Known or potential causes of infertility include genetic abnormalities, environmental, occupational, and infectious agents, certain diseases, delayed childbearing, and behavioral risk factors. We do not know what proportion of the infertility burden can be prevented, but it may be substantial.
The authors provide examples such as effects of sexually transmitted infections, as well as environmental and occupational hazards, and concerns that some risk factors for infertility may disproportionately affect those experiencing “social and racial disparities in health status.”
The plan includes four main goals:
1) To reduce the burden of infertility and impaired fecundity in the United States by promoting behaviors that maintain fertility, by promoting prevention, early detection, and treatment of infections (such as chlamydia) and other medical conditions that lead to infertility, and by removing or reducing environmental and occupational threats to fertility;
2) To improve access to the diagnosis and treatment of infertility and eliminate disparities in infertility care;
3) To improve the efficacy and safety of infertility treatment; and
4) To improve the quality of life of people who live with infertility in the US.
The plan outline document lists numerous strategies for surveillance, prevention research, policy development, evidence-based patient care guidelines, public education, expanded prevention and infertility care services, and other approaches, which should form the basis of a more detailed full action plan.