Fertility challenges affect a huge segment of the population, yet access to care remains far from adequate. According to the World Health Organization (World Health Organization, 2023), 1 in 6 people globally experiences infertility, underscoring an urgent need to improve access to fertility services.

Despite this widespread need, fertility treatments are often inaccessible due to high costs and limited availability, with most care paid for out-of-pocket and causing financial hardship for patients.

The U.S. exemplifies this gap: an estimated 12.2 million Americans (American Society for Reproductive Medicine, 2022) face infertility, but there are only about 1,351 reproductive endocrinologists (fertility specialists) to serve them, mostly clustered in urban centers.

As regional and community hospitals brace for the financial headwinds of proposed Medicaid reimbursement cuts, hospital leaders are under pressure to find new, high-impact ways to diversify revenue, strengthen care delivery, and meet the evolving needs of their communities.

One timely and often overlooked strategy? Adding fertility care as a service line.

We’ve been sold a narrative of panic: collapsing birth rates, aging populations, ticking biological clocks. But the truth, as highlighted in a powerful piece by UNFPA, is far more human and far more hopeful.

The real fertility crisis isn’t a shortage of babies. It’s a shortage of agency.

The fertility industry in the United States continues to grow rapidly, with market projections showing expansion from $8.9 billion in 2023 to an estimated $16.8 billion by 2028. Yet beneath this growth lies a troubling reality: a deeply fragmented ecosystem that often fails the very patients it aims to serve. My personal journey navigating this system recently as a patient has revealed how structural inefficiencies create emotional and financial burdens for patients, even for those of us who work within the industry.