A global survey on reproductive endocrinology and infertility training and care services

Infertility affects around 48.5 million couples worldwide. Training in reproductive endocrinology and infertility (REI) is a key step in expanding access to high quality infertility care. The present study aimed to explore the availability of basic and subspecialty REI training opportunities and infertility services across multiple countries on all continents.

A cross-sectional study of obstetrics and gynecology (Obs&Gyn) trainees and young specialists to evaluate REI training/exposure and infertility services was conducted by the World Association of Trainees in Obstetrics and Gynecology (WATOG) between December 2023 and April 2024.

Most of the study respondents volunteered that REI training modules were included in their basic Obs&Gyn residency programs (n = 88, 81.5%). However, less than one-half (n = 52, 48.1%) reported the availability of accredited REI subspecialty training programs in their countries. Most of those who reported non-availability of REI subspecialist training were from low- and middle-income countries (LMICs) (32/39, 82.1%). Less than one-fourth (21/88, 23.9%) of those who reported receiving REI training as part of their basic Obs&Gyn residency expressed satisfaction with the quality of training they received, and less than a third (n = 35, 32.4%) were confident in their ability to evaluate and treat infertile couples. While nearly all (106, 98.1%) the respondents volunteered that infertility and in vitro fertilization (IVF) services were provided in their countries, 51.4% stated that IVF was funded out-of-pocket by clients, especially in LMICs.

There is paucity of accredited REI subspecialty training programs and funding for infertility services, especially in LMICs. There is a need to increase and improve REI training opportunities and exposure during basic Obs&Gyn residency and subspecialization, as well as funding for infertility services, especially in LMICs.