In our March 2016 Views and Reviews section, we discussed the large amount of data indicating that psychological stress reduces in vitro fertilization (IVF) success (1). We referred to a landmark study showing that increased diastolic blood pressure was highly predictive of poor IVF outcomes. I can identify with those findings. My diastolic pressure was over 90 during my internship and is now under 70. When my IVF program was first housed in the university, a patient would come back to my office completely unglued because the pharmacy had run out of gonadotropins.

Access to care may be enhanced by modifying standard assisted reproductive technology practice to make fertility treatment cheaper, simpler, and better tolerated by patients.

Male infertility is underrepresented as a disease. Acknowledging and addressing the barriers in access to care for male infertility is necessary for improving reproductive care and outcomes in the United States.

Many infertile individuals do not seek out treatment or drop out of treatment owing to the psychological burden of infertility.

Infertility is a global problem affecting all ethnic, racial, and religious groups. Nevertheless, only a minority of the U.S. population has access to treatment. Additionally, for those who do engage in treatment, outcomes are disparate among various ethnic and racial groups. This article addresses racial and ethnic disparities regarding rates of fecundity and infertility, access to care, and assisted reproductive technology outcomes.

Improved underwriting of infertility care must constitute a central goal of the professional societies concerned with access to and use of United States infertility and assisted reproduction technology services.

Despite impressive advances in the field of reproductive medicine, access to care is a persisting challenge. These articles explore barriers to fertility care and propose a constructive path forward.