Telehealth in Assisted Reproductive Technology to Improve Disparities in Access to Care in Rural Georgia

Abstract

Background: Infertility, the inability to conceive after one year of unprotected regular intercourse, affects one in six couples of reproductive age in the United States. Assisted reproductive technologies (ART) are often employed to treat infertility among couples. Although ART treatments have been implemented for several decades, there still remains significant disparities, particularly the southeastern United States. Thus, only 60% of women in Georgia are able to proceed with treatment due to the scarcity of fertility specialists, cost, and distance to travel to a fertility clinic. Telehealth is a tool that has been implemented across the United States in multiple specialties that allows patients to meet with their physician remotely; however, it has yet to be utilized in reproductive medicine. This study, a regional telehealth program was implemented to close the gap and improve existing ART access disparities in Georgia and neighboring states. The telehealth program's ART outcomes and patient satisfaction of those living remotely was the primary focus of this research project. Results: A total of 97 patients were identified, of which 57% were younger than 35 years old (y/o), and 43% were older than 35 years old. The overall clinical pregnancy rate was 64% (69% < 35 y/o and 31% > 35 y/o) with an overall live birth rate of 48% (69.77% <35 y/o and 30.23% > 35 y/o). The cohort’s average number of in person appointments was 3 (0.82 +/- SD). The survey response rate was 70/97 (72.2%). Overall, 50% of responders were < 35 y/o and 50% > 35 y/o. The average number of responders' visits was 4.44 (1.54 +/-SD), and the average distance traveled was 143.12 miles (49.21 +/-SD). The clinical pregnancy rate was 32 (76.16%) for surveyors, with a live birth rate of 25 (59.52%). Overall, 56% of patients reported being extremely satisfied with the telehealth service to enhance ART access, and 87.72% of patients stated they would recommend telehealth use for ART to others.