Gynecology and Reproductive Medicine: Demand, Workforce and Access

Summary

This report examines gynecology and reproductive medicine with a global focus on infertility burden and a United States focus on IVF activity and the obstetrics and gynecology (ob/gyn) workforce. WHO estimates that about 17.5% of adults experience infertility in their lifetime ¹. In the United States, SART-member clinics reported 449,772 IVF treatment cycles in the latest available data, with 97,549 cycles resulting in a live birth ⁴. Workforce projections forecast a metro ob/gyn workforce 11.7% smaller a decade from now ⁷. Principal risks include a constrained training pipeline ⁶⁸, and large evidence gaps on costs, waiting times, equity and digital health. The pack contains no verified market size, so commercial sizing is not assessed. Outlook (interpretation): demand for fertility and gynecologic care is likely to remain high, and workforce capacity and geographic access are likely to be the binding constraints.

Key findings

1. 1

   Infertility affects about one in six adults over a lifetime

   WHO estimates lifetime infertility prevalence at about 17.5% of the adult population, roughly one in six people worldwide. Period prevalence is 12.6% ¹².

   Confidence: High
2. 2

   The burden is similar in high-income and low- and middle-income countries

   Lifetime prevalence is 17.8% in high-income countries and 16.5% in low- and middle-income countries. WHO also notes a persistent lack of national infertility data in many countries ¹.

   Confidence: High
3. 3

   US IVF activity is large and practice has shifted toward single embryo transfer

   SART-member clinics reported 449,772 IVF cycles and 97,549 cycles with a live birth. About 79% of embryo transfer cycles now use elective single embryo transfer ⁴. These are clinic-reported figures published by an industry association, and a separate SART page shows a different cycle total ⁵.

   Confidence: Medium
4. 4

   Ob/gyn workforce shortfalls are projected, with uneven geographic effects

   A workforce projection reported by Medscape finds the metro ob/gyn workforce 11.7% smaller and the nonmetro workforce 5.3% smaller a decade from the reference period. Several states, including Nevada and Arizona, are projected to meet less than 70% of demand. The study did not separate general ob/gyns from subspecialists ⁷.

   Confidence: Medium
5. 5

   Training capacity is not keeping pace with anticipated needs

   A peer-reviewed study reports that graduate medical education residency capacity in obstetrics and gynecology has not expanded to meet anticipated needs ⁶. A vendor report states that residency positions grew only about 9% over the period it reports ⁸. The vendor figure should be treated with caution.

   Confidence: Qualitative
6. 6

   Definitions and data gaps limit comparison across settings

   Varying measurement definitions make infertility prevalence hard to compare across settings ³. The pack has no verified data on costs, waiting times, public versus private provider split, or equity by income or ethnicity.

   Confidence: Qualitative

1Industry definition and scope

This report covers the clinical and related services in gynecology and reproductive medicine. It includes gynecologic and obstetric care delivered by ob/gyn physicians, and assisted reproductive technology (ART) such as in vitro fertilization (IVF). The source pack contains no formal industry classification, so the boundaries are set by the sources that are available.

Geographic scope is global for infertility prevalence ¹³, United States for IVF activity ⁴⁵ and for workforce data ⁶⁷⁸⁹, and Japan for one workforce study ¹⁰. The reporting period is the latest available data. Figures from different sources are not combined unless the source itself reports them together.

Terminology matters. Infertility is reported as lifetime or period prevalence, and the two measures are not interchangeable ¹². Sources do not consistently separate general ob/gyns from subspecialists such as maternal-fetal medicine ⁷⁸, so workforce counts may mix categories.

Segments covered are fertility and ART services, the general gynecologic and obstetric workforce, and demand indicators. Devices, drugs and digital health products are outside the verified evidence in the pack and are not assessed.

Scope was set by the sources in the pack. No external classification was applied.

2Market size, structure and value chain

The source pack contains no verified global or national market size, revenue or growth figure for gynecology and reproductive medicine devices, drugs or services. Any dollar value would be unsupported, so this report does not provide one. Demand indicators are used instead to describe the sector.

Demand is anchored in infertility prevalence. WHO estimates lifetime prevalence at about 17.5% of adults and period prevalence at 12.6% ¹². A peer-reviewed systematic review pooled 65 studies for lifetime prevalence and 69 for 12-month period prevalence ³. The authors note that differing definitions make cross-setting comparison difficult ³.

The care pathway runs from primary and gynecologic care, through diagnosis and fertility assessment, to ART treatment cycles, embryo transfer and pregnancy outcome. In the United States, 364 fertility clinics reported data to SART in the latest available period ⁴. The pack does not show how value is divided among clinics, laboratories, drug suppliers and insurers. Key stakeholders include clinics, physicians, residency programs, professional societies, data bodies such as SART, and workforce analysts ⁴⁶⁸.

Revenue models and the public versus private provider split were not found in the pack. The reliable public versus private split for gynecology and fertility services was not found. Revenue models are therefore described only qualitatively, and no share of activity is assigned to provider types.

• Lifetime infertility prevalence, adults 17.5percent Observed Global, Latest available data [1]
• IVF treatment cycles reported by SART-member clinics 449,772cycles Observed United States, Latest available data [4]

No market value estimate is made because the pack has no verified market figures.

3Customers, demand and adoption

End users include individuals and couples with infertility and women who need gynecologic and obstetric care. Prevalence is substantial in both high-income and low- and middle-income countries ¹, which suggests that demand is not confined to wealthier markets. WHO also calls for disaggregated national data because many countries lack it ¹.

Practice has changed in the United States. About 79% of embryo transfer cycles now use elective single embryo transfer, a major shift over the past decade ⁴. This is a reported change in practice. The pack does not give outcome comparisons by transfer strategy, so it does not show whether the shift changed outcomes.

Affordability and access are the largest evidence gaps for patients. The pack contains no verified cost or out-of-pocket figures for IVF or gynecologic procedures, no verified US national waiting-time data for gynecology or fertility services, and no verified data on equity by income or ethnicity. Purchasing criteria such as price, wait time and provider quality therefore cannot be quantified from the sources.

Demand direction varies by country. A peer-reviewed study on Japan suggests that aging and declining birth rates may reduce future demand for obstetrics and gynecology services ¹⁰. This is the study's projection, not a verified trend, and it does not apply to other countries.

• Embryo transfer cycles using elective single embryo transfer 79percent Observed United States, Latest available data [4]

Only three comparable WHO lifetime prevalence figures are charted. Period prevalence is not charted because no income-group split was given for it.

4Competitive landscape and key players

The source pack contains no company-level market share, revenue or competitive positioning data for gynecology or reproductive medicine providers. Comparable provider examples are therefore limited. This section compares provider types and information sources rather than ranking companies.

Fertility clinics participating in SART are one provider type. SART reports 364 clinics that submitted data ⁴. This is a count of participants, not a market share, and the pack does not show clinic ownership or the public versus private split.

Information providers differ in their incentives and methods. SART is an industry association that publishes clinic-reported national summaries ⁴⁵. Medicus Healthcare Solutions is a recruitment firm that reports about 49,000 ob/gyns and about 1,100 maternal-fetal medicine specialists in the United States ⁸. Its figures are vendor claims and are not verified against primary workforce data. The American Journal of Managed Care reports a Doximity analysis of 43,000 full-time board-certified ob/gyn practitioners ⁹. The analysis is reported secondhand and the method is not described in the pack.

Concentration cannot be measured from the pack. Competitive pressure is mainly visible as competition for scarce workforce across geographic areas. Sources point in different directions: a peer-reviewed study emphasizes deficiencies in non-metropolitan areas and the West ⁶, while a projection reported by Medscape shows a larger percentage decline in metro areas ⁷. The two may measure different things, such as distribution versus change, but the pack does not reconcile them.

Comparison is limited to provider types and information sources because verified company-level data is absent from the pack.

5Technology, operations and workforce

The strongest technology data in the pack concerns ART practice patterns, specifically the use of elective single embryo transfer at about 79% of US cycles ⁴. The pack contains no verified adoption rates for robotic surgery, genomic testing or other clinical innovations in gynecology, and no verified data on digital health adoption. Emerging approaches therefore cannot be separated from established practice on the evidence available here.

The US ob/gyn workforce is aging. Less than 1 in 5 (19%) of OB/GYNs are younger than 40 ⁹. Residency positions grew only about 9% over the period reported ⁸, and a peer-reviewed study finds that residency capacity has not expanded to meet anticipated needs ⁶. Vendor and news figures for total ob/gyn numbers conflict with one another and could not be checked against primary federal publications.

Geographic access is a significant operational issue. A peer-reviewed study identifies notable physician deficiencies in non-metropolitan areas and the West ⁶. A projection reported by Medscape expects the metro ob/gyn workforce to be 11.7% smaller and the nonmetro workforce 5.3% smaller a decade from the reference period. Nevada and Arizona are projected to meet less than 70% of demand ⁷. The projection draws on data from an earlier period and does not separate general ob/gyns from subspecialists ⁷.

Productivity, staffing models and service models are not documented in the pack. Interpretation: the workforce constraints above are likely to push providers toward workforce planning and care-team models, but the pack does not verify this.

• Ob/gyn physicians younger than 40 19percent of OB/GYNs Observed United States, Latest available data [9]

Workforce counts are used with caution because they come from a vendor report and a news report of a study.

6Regulation, standards, risk and sustainability

The source pack contains no statutes, regulator publications or binding standards for gynecology or reproductive medicine. This section therefore does not state any binding legal requirement. Licensing, reimbursement rules, privacy law and clinical safety standards cannot be verified from the pack. The relevant jurisdiction for the US data is the United States, but a regulatory map is not supported by the sources.

Quality reporting is a visible area. SART publishes national summaries and outcome tracking for cycles initiated for egg retrieval over a two-year period, covering fresh and frozen transfers ⁵. Reported totals differ between sources: the press release gives 449,772 IVF cycles ⁴, while the public snapshot gives 431,746 total cycles ⁵. The basis of each figure is not reconciled in the retrieved pages, so the two should not be added or directly compared.

Infertility and reproductive data are sensitive. The pack contains no verified privacy or data protection requirements. All figures in this report are population-level aggregates and must not be read as individual medical advice.

Equity and sustainability are largely unmeasured. The pack has no verified national data on outcomes or access by income or ethnicity, and no environmental data for the sector. Workforce shortfall is the principal operational risk visible in the evidence ⁶⁷.

This section separates what the pack shows from what it does not. It is not regulatory or legal advice.

7Challenges, opportunities and case examples

The main constraints are workforce shortage and limited training capacity ⁶⁷⁸, gaps in cost, waiting-time and equity data, and inconsistent prevalence definitions ¹³. In many countries, national infertility data are lacking ¹. These constraints make it hard to plan services or measure access.

Opportunities include wider use of standardized practice, such as elective single embryo transfer ⁴, better disaggregated national data as called for by WHO ¹, and geographic workforce planning based on the projections for metro and nonmetro areas ⁶⁷.

Case example one is SART. Its national summary reports 449,772 IVF cycles, with 97,549 cycles resulting in a live birth, across 364 reporting clinics ⁴⁵. It shows how a national registry can make activity visible, although it is an industry association source.

Case example two is Japan. The Japan Society of Obstetrics and Gynecology proposed recruiting 500 OBGYN residents annually in its Grand Design ¹⁰. This is a proposal, and the pack does not show whether it was implemented or what results followed.

Case example three is the Doximity analysis reported by the American Journal of Managed Care. It identified the 10 metropolitan areas most likely to face shortage among 43,000 full-time board-certified practitioners ⁹. The pack does not list those areas, so they cannot be named here. Comparable examples were limited in the pack, and no company-level case study could be verified.

Examples are drawn only from the pack. The pack contains few comparable company examples.

8Outlook and strategic implications

Interpretation of the evidence suggests three near- to medium-term scenarios. In the base case, demand for infertility care stays high because prevalence is substantial in all income groups ¹, while workforce projections show shortfalls, especially in some states ⁷. In an upside case, standardized practice and better national data improve planning and access ¹⁴. In a downside case, training capacity fails to expand ⁶⁸ and states fall further below demand.

Key uncertainties include the reliability of workforce projections, which do not separate subspecialists ⁷, the unreconciled SART totals ⁴⁵, and the absence of verified cost and access data. Any investment or service decision should rely on primary and current data that the pack does not provide.

Practical implications differ by stakeholder. Providers should plan for workforce constraints and geographic gaps. Policymakers and payers need national data on cost, waiting times and equity before they can judge access. Suppliers and investors should not rely on market-size claims, because the pack has none. Researchers should use common definitions for infertility prevalence ³.

Scenario language is the writer's interpretation of the evidence and is labeled as such.

9Conclusion

Infertility is common across income groups, and US IVF activity is large and increasingly standardized. The strongest evidence points to workforce shortfalls and uneven geographic access. The most defensible takeaways are that demand is substantial, the workforce is constrained, and cost, waiting-time and equity data are not yet available to measure access.

How this was built

Sources

1. 1

   1 in 6 people globally affected by infertility: WHO

   World Health Organization Official statistics

2. 2

   Infertility prevalence estimates (latest available data)

   World Health Organization Official statistics

   iris.who.int
3. 3

   Infertility prevalence and the methods of estimation across studies: a systematic review and meta-analysis

   Human Reproduction Open (peer-reviewed systematic review) Peer-reviewed

   ncbi.nlm.nih.gov
4. 4

   For the First Time, More Than 100,000 Babies Born Through IVF in the U.S. in a Single Year

   American Society for Reproductive Medicine, citing Society for Assisted Reproductive Technology (SART) data Industry association

   asrm.org
5. 5

   SART National Summary Report (public snapshot)

   Society for Assisted Reproductive Technology Industry association

6. 6

   Geographic variation in supply, demand, and adequacy of the obstetrics and gynecology physician workforce: forecasts and shortage risks in the United States

   Peer-reviewed study (PMC, national journal article) Peer-reviewed

   ncbi.nlm.nih.gov
7. 7

   Ob/Gyn Workforce Projections Suggest Substantial Shortfalls Over Next Decade

   Medscape (news report on a peer-reviewed workforce projection study) News report

8. 8

   Insights Into the Growing OB/GYN Shortage

   Medicus Healthcare Solutions (vendor/recruitment firm) Vendor report

   medicushcs.com
9. 9

   Physician Shortage Likely to Impact OB/GYN Workforce in Coming Years

   American Journal of Managed Care (AJMC) News report

   ajmc.com
10. 10

    Estimating Future Obstetrics and Gynecology Workforce Needs in Japan

    Cureus (peer-reviewed study, Hokkaido University authors) Peer-reviewed

    ncbi.nlm.nih.gov