Abstract
PurposeGeographic disparities for assisted reproductive technology (ART) continue to exist. Travel cost and time off work may create additional barriers for patients living remotely. Implementing telehealth can alleviate these barriers by reducing office visits. The aim of this study was to evaluate patient satisfaction with telehealth during ART.MethodsThis was a cross-sectional survey and retrospective cohort study. Patients living remotely who underwent ART utilizing telehealth between 2015 and 2018 at a single institution were selected for the telehealth group. The non-telehealth control group included randomly selected patients who underwent IVF at the same institution between 2015 and 2018. Demographic variables and treatment outcomes were obtained for both groups. A patient satisfaction questionnaire was distributed to telehealth patients. Statistical analysis using χ2 test was performed to compare ART outcomes between both groups.ResultsNinety-seven control and 97 telehealth patients were included. For telehealth patients, the mean number of office visits and distance traveled was 2.9 (± 0.8 SD) and 143.1 miles (± 49.2 SD) respectively. 58.8% of patients completed the survey. 44/57 participants had an oocyte retrieval and 42/44 underwent embryo transfer. For those who completed the survey, the clinical pregnancy rate was 31/44 and the live birth rate was 25/44. There was no difference in treatment outcomes between telehealth compared to controls. 73% of patients were highly satisfied with telehealth.ConclusionsTelehealth can improve access to ART in underserved areas and results in high patient satisfaction. Reproductive health providers could consider telehealth as a safe and efficacious tool to ameliorate geographic disparities.
Highlights
Many challenges exist in providing accessible and costeffective reproductive care
Geographic barriers remain a key contributor to these statistics, with 18 million reproductive-aged women lacking any regional access to assisted reproductive technology (ART) and another 7 million having access to only a single IVF clinic [2,3,4]
In the setting of ART, limited geographic access poses a unique challenge since multiple consultative appointments are often required along with frequent office visits for serial ultrasonography and blood draws during an IVF cycle
Summary
According to the U.S National Survey of Family Growth, only 38% of infertile women seek fertility services and only 60% of reproductive age women who require assisted reproductive technology (ART) for procreation are able to proceed [1]. Geographic barriers remain a key contributor to these statistics, with 18 million reproductive-aged women lacking any regional access to ART and another 7 million having access to only a single IVF clinic [2,3,4]. In the setting of ART, limited geographic access poses a unique challenge since multiple consultative appointments are often required along with frequent office visits for serial ultrasonography and blood draws during an IVF cycle. The majority of infertility clinics are located in densely populated cities with high median incomes as well as states where insurance coverage for fertility services is mandated [4, 5]. There are states that have 0–1 IVF centers as reported by the CDC, leaving a considerable number of communities underserved [6]
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