The Fertility Passport Program: A Pilot Program to Improve Infertility Care in Low Resourced Populations

As residents in an urban safety-net hospital, we have seen firsthand the struggles and frustrations both patients and providers experience in their quest for comprehensive fertility care. We care deeply about our patients, many of whom are desperate for a family but lack basic knowledge of reproductive anatomy and conception. Often, our clinic visits are spent teaching patients about the reproductive system, common causes of infertility, and preconception counseling. This leaves little time for discussion of the steps needed to complete the workup in a timely matter. Our coresidents express frustration and fatigue when a chief complaint is fertility, as it can feel hopeless to accomplish anything for these patients. The issue of fertility for women in general is not insignificant; the WHO has calculated that over 10% of women worldwide are affected by infertility. This problem remains inadequately addressed, especially in low-resourced settings1. Much of the existing research in resource-poor infertility care centers on the international community, while the low-resourced, urban American population struggles silently with this problem. These patients are often those who could most benefit from a comprehensive workup due to increased risks from poverty, poor education, early sexual debut, and sexually transmitted infections2. Addressing the frustrations of patients and providers in completing the fertility workup in settings without infertility specialists and fragmented care remains a critical concern. The desire to get residents “back to the bedside,” to truly help our deserving patients understand their reproductive system, and to complete their workup in a timely fashion, is what inspired the Fertility Passport Program. The program has two goals: first, to increase patients’ understanding and ownership of their reproductive life cycle and their infertility journey. Second, to streamline and simplify the management of these patients,