In today’s digital age, the availability of information on fertility and reproductive health is abundant. While this accessibility is largely a good thing, it also poses the risk of spreading misinformation. In fact, global agencies like UNICEF consider misinformation a “pressing public issue”. As such, it is important for those seeking to understand more about their fertility and reproductive health to be cautious about where they get their information from.
By finding trusted sources such as ebooks, navigating this sensitive topic can be more pleasant and less confusing. Besides its natural advantage of being easily accessible, these ebooks are written by fertility experts. That means their works provide accurate and evidence-based information despite today’s misinformation age, with many providing references that allow readers to verify information.
Here’s more on how today’s ebook platforms can help you learn more about fertility, as well as 3 Fertility Ebooks titles to get you started.
How ebook platforms help
The advent of ebook platforms has given readers access to a plethora of information on a wide range of topics, which can be accessed with just a few taps of their screen. With these platforms, readers can have a seamless and immersive reading experience regarding their genre and topic of choice, from popular fiction books to informative studies. Take the ebooks on Everand: its diverse collection of titles, including those that cover fertility, are guaranteed to have authentic and reliable information regarding their reproductive health. The platform also only shares access to titles that are written not only by reputable authors but also by experts in the given health field. That includes works published by women’s hormone expert Alisa Vitti, like Womancode and In the FLO, and Harvard-educated physician-scientist Sara Gottfried, who shares her insights on hormone signaling through ebooks like The Hormone Cure. The platform also allows users to take and access books like these anywhere with ease.
Additionally, the Digital Public Library of America provides ebook access to millions of items from libraries, archives, and museums across the United States, making it an inclusive and accessible platform for individuals seeking information on important topics including health and fertility. With a dedication to providing access to diverse perspectives and voices, this library features resources like fertility rate health indicator reports, fertility-related behavior studies, and various other resources from academic institutions, government offices, nonprofit organizations, and privately-run think tanks.
With ebook platforms opening up a large collection of valuable information, it may be hard to decipher where to begin. Try starting with these 3 Fertility Ebooks titles to learn more about fertility.
Infertility: The Hidden Causes
by Sandra Cabot M.D.
Many misunderstand infertility as a disease when it is, in fact, an underlying health problem. While the causes of infertility are varied and complex, there are often hidden factors that contribute to a couple’s inability to conceive. Integrative medicine doctor Sandra Cabot explores these often overlooked factors and sheds light on the possible reasons for infertility that are not commonly addressed.
By touching upon conditions such as polycystic ovary syndrome, pre-cancer, and urinary incontinence—which is also discussed on our post Does Stress Incontinence Cause Infertility?—the ebook urges individuals to seek appropriate medical attention and explore alternative approaches to addressing their fertility challenges.
Queer Conception: The Complete Fertility Guide for Queer and Trans Parents-to-Be
by Kristin Liam Kali
Traditionally, the field of reproduction and fertility has been dominated by heteronormative and cisnormative perspectives, often excluding the experiences of LGBTQ+ individuals. Queer Conception was written by transgender activist and scholar Kristin Liam Kali as a way to challenge these normative frameworks and broaden the conversation around reproductive rights to include the unique needs of queer and transgender individuals.
At the core of this title is the recognition that LGBTQ+ individuals may pursue family-building through a variety of means beyond traditional heterosexual reproduction. The ebook acknowledges and validates these non-traditional pathways to parenthood, affirming the autonomy of LGBTQ+ individuals in making decisions about their reproductive futures.
The Infertility: Cure The Ancient Chinese Wellness Program for Getting Pregnant and Having Healthy Babies
by Randine Lewis, Ph.D.
Using case studies and personal anecdotes from her clinical practice, licensed acupuncturist and doctor of Oriental medicine Randine Lewis, Ph.D., came up with The Infertility. The ebook serves as a guide to the basic principles of traditional Chinese medicine, covering a range of treatment methods, from acupuncture to herbal medicine and other therapeutic techniques.
It explains how these modalities help regulate the menstrual cycle, nourish the endometrial lining, enhance egg quality, and improve sperm health. Through integrations of Western medical knowledge with traditional Chinese medicine, The Infertility provides a balanced and comprehensive approach to addressing infertility issues.
Assisted reproductive technology (ART) has transformed the landscape of infertility treatment, providing a ray of hope to countless couples trying to conceive. In-vitro fertilization (IVF) is one of the most commonly used ART methods, accounting for over 99% of all ART cycles performed in the United States. However, despite the progress made in this field, disparities in IVF outcomes and access persist, and racial factors play a significant role in exacerbating these disparities.
What is DEI?
Diversity, equity, and inclusion (DEI) are crucial components of any healthcare system, including IVF clinics. DEI practices help ensure that all patients are treated equitably, regardless of their race, ethnicity, gender, sexual orientation, or socioeconomic status. By adopting DEI practices, IVF clinics can better serve and advocate for patients and their loved ones, leading to better outcomes and a higher quality of life.
One of the key benefits of DEI practices is that they promote patient-centered care. Patient-centered care is an approach to healthcare that places the patient at the center of their care experience. This approach emphasizes listening to patients’ needs and preferences, involving them in decision-making, and providing care that is respectful of their values, beliefs, and cultural background. When IVF clinics adopt DEI practices, they create an environment that is welcoming and supportive of all patients, which can improve patient satisfaction and outcomes.
Cultural sensitivity is another important aspect of DEI practices in IVF clinics. Cultural sensitivity refers to the ability to understand and appreciate the cultural backgrounds of patients and how these backgrounds may affect their healthcare experiences. For example, a patient from a different cultural background may have different beliefs about fertility treatment, and IVF clinics that are culturally sensitive can adapt their services to better meet these patients’ needs.
In addition to promoting patient-centered and culturally sensitive care, DEI practices can also improve health outcomes for patients. Studies have shown that patients who receive care that is culturally sensitive and responsive have better health outcomes than those who do not. For example, a study of African American women undergoing infertility treatment found that those who received culturally sensitive care had higher pregnancy rates than those who did not.
Finally, DEI practices can help IVF clinics attract and retain a diverse and talented workforce. When IVF clinics prioritize DEI, they create an environment that is welcoming and supportive of all employees, regardless of their background. This can help attract and retain employees who are representative of the communities they serve, which can improve the quality of care and outcomes for patients.
There are several reasons why racial disparities in IVF outcomes and access exist. One of the most significant factors is the cost of treatment. IVF is an expensive procedure that can cost tens of thousands of dollars per cycle, making it out of reach for many individuals and families, especially those without insurance coverage. Unfortunately, insurance coverage for infertility treatment is not mandated in most states, and even in states where it is mandated, the scope and extent of coverage may vary significantly. This lack of access to affordable IVF treatment disproportionately affects low-income individuals and people of color, who are more likely to be uninsured or underinsured.
Another factor contributing to disparities in IVF outcomes is the quality of care. Studies have shown that Black women have lower success rates with IVF, even after controlling for age, infertility diagnosis, and other confounding factors. This disparity may be due in part to differences in the quality of care provided to Black women. For example, Black women may be less likely to receive appropriate preconception counseling, have longer wait times for appointments, and receive lower-quality care during the IVF process.
Finally, there is a significant lack of diversity in the field of reproductive medicine. Black individuals and other people of color are significantly underrepresented in the field, both as patients and as practitioners. This lack of diversity may contribute to the disparities in care and outcomes seen in IVF treatment. For example, a study found that Black women who received care from Black physicians were more likely to have successful IVF outcomes than those who received care from non-Black physicians.
Disparities in IVF outcomes and access are complex and multifactorial, with racial factors playing a significant role. Addressing these disparities will require a comprehensive approach that includes addressing the cost of treatment, improving the quality of care provided, and increasing diversity in the field of reproductive medicine. Legislation such as the ACA presents an opportunity to expand coverage for infertility treatment and improve disparities in fertility prevention, but more needs to be done to ensure that all individuals have access to the care they need to build their families.
DEI and Inclusive and Accurate Medical Language
The use of medical language has a significant impact on the way we think about and understand health conditions. Historically, medical language has been focused on gender, with certain conditions and symptoms being attributed exclusively to either male or female bodies. However, this approach can be problematic as it ignores the fact that gender is not binary and fails to account for individuals whose gender identity does not align with their biological sex.
As such, a more inclusive and accurate approach to medical language would be to shift the focus from gender to anatomy, conditions, and symptoms. This means using language that describes specific body parts and functions, rather than assuming that certain conditions or symptoms are exclusive to one gender or another.
For example, instead of using terms like “male infertility” or “female infertility,” medical professionals can use terms like “sperm count” or “ovulation problems” to describe specific conditions or symptoms. Similarly, rather than using gendered terms like “menstrual cramps” medical professionals can use more specific language like “dysmenorrhea” to describe the symptoms.
By shifting the focus of medical language from gender to anatomy, conditions, and symptoms, we can ensure that all individuals receive accurate and inclusive healthcare. This approach also acknowledges that individuals may have a range of gender identities and expressions, and that these identities do not necessarily correspond to their biological sex.
It is important to note that shifts in medical language are not just a matter of political correctness, but rather a crucial step in providing equitable healthcare. Inaccurate or exclusionary medical language can lead to misdiagnosis, delayed treatment, and a lack of access to appropriate care for marginalized communities. In contrast, more inclusive and accurate medical language can help ensure that all individuals receive the care and support they need to maintain their health and well-being.
DEI and LGBTQIA+
Diversity, equity, and inclusion (DEI) practices can greatly improve fertility outcomes and create a more welcoming environment for LGBTQIA patients in several ways:
Access to Care: DEI practices ensure that all patients have equal access to fertility care, regardless of their gender identity or sexual orientation. This includes providing education and resources to LGBTQIA patients about their fertility options, as well as making fertility services more affordable and accessible.
Culturally Sensitive Care: Fertility clinics that adopt DEI practices can provide culturally sensitive care to LGBTQIA patients. This involves understanding the unique challenges that LGBTQIA individuals face when seeking fertility treatment and developing care plans that are tailored to their specific needs.
Inclusive Language: Fertility clinics that use inclusive language can create a more welcoming environment for LGBTQIA patients. This involves using gender-neutral language and avoiding assumptions about gender and sexual orientation.
Provider Diversity: DEI practices promote provider diversity, which is essential in creating a more welcoming and inclusive environment for LGBTQIA patients. Clinics should strive to hire providers who are representative of the diverse patient population they serve.
Patient Advocacy: Fertility clinics can serve as patient advocates by advocating for policies that promote DEI in healthcare. This includes supporting legislation that protects the rights of LGBTQIA patients, as well as advocating for insurance coverage for fertility treatments.
The table below gives a sample DEI plan, and provides space to record a point person on the executive team, DEI group members who might participate, and a strategy to include staff from the whole company.
| DEI Initiative by Department | Activities | Executive Staff | DEI Group Members | Strategy to include all staff |
| Human Resources | Recruiting – all levels | |||
| Talent Pipeline – Bridging the gap to local schools and Universities | ||||
| Diversity Survey: What is does the diverse make-up of your company look like? • Race • Gender More than two options (MANY options) • Religion • Age • Sexual orientation • Parental status • Marital status • Position • Disability (physical or otherwise) Equity: • Salary equity • Equitable promotions and raises • Diversity in leadership positions? Inclusion: Understanding the employee experience. • “I can voice a contrary opinion without fear of negative consequences” • “people from all backgrounds have equal opportunities to succeed ” • “perspectives like mine are included in the decision-making at my company” | ||||
| Marketing | Analyze your social media feeds for each clinic. Does your social media feed display a range of skin tones? A range of relationships? A spectrum of genders? | |||
| Your ads and creative content should show diversity. Captions and posts should use inclusive language. | ||||
| Amplify publications related to disparity in outcomes, eduction, or access. Show you care about these issues. | ||||
| “Like,” follow, and occasionally share (amplify) the content of diverse creators. | ||||
| Ask physicians and scientists to participate in diverse infertility events and share. Ask them to use inclusive language in social media posts. Educate them on inclusive language. | ||||
| Can you create sections on the IVF Clinic website that speaks to the lived experience of BIPOC, LGBTQI+. Can you use inclusive language whenever possible “Pregnant persons” People with a uterus” “Birthing person” “Chest Feeder”? | ||||
| Clinical | Change all paper or electronic forms to use inclusive language (LGBTQ, race, and ethnicities). Patient and Partner (instead of female and male) | |||
| Increase visual representation in waiting rooms, magazines, pictures, baby pictures | ||||
| Attendance at Men Having Babies or other diverse conferences or symposia | ||||
| Can you parse your SART data or EMRs and strategize for one abstract / publication a year on a topic related to diversity? What are the IVF success rates of BIPOC at your IVF clinic? What are the ethnic backgrounds of the internal donor egg banks? (Can you recruit more diverse backgrounds?) Do the patients reflect the diversity of the area surrounding your IVF clinic? Does your patient satisfaction surveys have queries for culturally sensitive and competent, or LGBTQI+ specific care? | ||||
| IVF Laboratory | Seminar on lab handling of HIV+ sperm and embryos. Education about SPAR processing. | |||
| Changes in lab protocols to accommodate egg donor splits for male:male couples. | ||||
| Coordinate with clinic for abstracts and papers related to DEI | ||||
| Internal Network | Mission, Vision, Contract with executive team | |||
| DEI newsletter, 2x per year posted on HR staff management platform and emailed to staff |
September is a great time to perform an FDA Compliance quality assurance audit in your IVF Lab!
This blog post will provide you with a month’s schedule of specific quality assurance activities that will keep your IVF lab compliant with FDA Title 21 Code of Federal Regulations (CFR) Part 1271 and College of American Pathologist inspections. It will also provide background on FDA and CAP requirements.
FDA requires prospective egg and sperm donors to be tested for HIV, Hepatitis B and C, chlamydia, and gonorrhea, and for stored embryos, eggs, and sperm to be labeled so they don’t get mixed up. The FDA has the power to inspect and shut down IVF labs if they don’t meet the legal requirements.
Donated reproductive tissue (eggs or sperm) are regulated as human cells, tissues, and cellular and tissue-based products (HCT/Ps). Any establishment that performs one or more manufacturing steps for HCT/Ps (recovery, processing, storage, labeling, packaging or distribution of products) must register with FDA and list their HCT/Ps in accordance with Title 21 Code of Federal Regulations (CFR) Part 1271.
Reproductive HCT/P donors are required to be screened for risk factors that may increase the chances of transmitting a communicable disease.
Donor screening consists of reviewing the donor’s relevant medical records for risk factors for, and clinical evidence of, relevant communicable disease agents and diseases. These records include a current donor medical history interview to determine medical history and relevant social behavior, a current physical examination, and treatments related to medical conditions that may suggest the donor is at increased risk for a relevant communicable disease.
FDA Donor HCT/P Eligibility Determination: 3 Necessary Factors
Donor screening must document three items: donor medical history (ie risk factor assessment), physical exam and review of other relevant medical records, and donor infectious disease testing. After those items are reviewed by a physician or responsible person, a donor eligibility determination can be made. Donors can be deemed “eligible” for anonymous donation, or “ineligible” (and therefore the donation can only be directed, not anonymous). An ineligible directed reproductive tissue donor can provide semen, oocytes, or embryos, to a specific recipient, and who knows and is known by the recipient before donation, provided they are counseled appropriately and sign a waiver.
What is the IVF lab’s responsibility for maintaining FDA compliance?
Both FDA and CAP have specific requirements for IVF labs to follow. The IVF laboratory must be registered with FDA and have a procedure for reporting device-related adverse patient events, donor records must include a statement of eligibility or ineligibility and a summary of the records used to make the donor-eligibility determination, and there must be a written procedure for investigating donor infections or adverse events after reproductive donor cells/tissues are received or implanted.
Donor cells/tissues must be labeled with the following information in accordance with the intended use:
- Unique identification code
- Description of the type of cells/tissue(s)
- Expiration date (if any)
- Warnings (if any)
- Name and address of the establishment that made the eligibility determination and made the cells/tissue(s) available for distribution
Furthermore, for testing performed by clinical lab staff in Endocrinology or Andrology, prior to clinical use of each modified FDA-cleared or approved test and laboratory-developed tests (LDTs), the laboratory must perform a validation study and prepare a written assessment of each of the following test method performance specifications. Whenever available, reagents and supplies used in the collection, processing and cryopreservation of gametes and/or embryos should be cleared or approved by FDA for human use.
Lastly, the entire staff should be competent in FDA related skills and knowledge, and the IVF laboratory director or designee must interact with agencies FDA, as appropriate, for laboratory-related matters.
| FDA Related CAP Requirements | |
| GEN.20351: Adverse Patient Event Reporting | |
| RLM.12455: FDA Registration | |
| RLM.12510: Donor Cells/Tissues Labeling | |
| RLM.12587: Donor Infection/Adverse Events Investigation | |
| DRA.11450: Director Responsibility – Interaction with Government or Regulatory Interaction | |
| COM.40350: Validation of Test Performance Specifications | |
| RLM.03480: FDA-Cleared/Approved Reagents and Supplies |
One Month Schedule of FDA related IVF Lab QA Activities
Start each month by answering “In Progress” to each question, then assign this survey to junior staff using the “assign” button. This will document both continuing education and quality assurance activities.
| Create or update a schematic map of all tank or canister eligibilities | Post up to date schematic in tank room(s). Download our editable template here! Tank-Schematic-1-1. |
| Review Tissue in Donor Canisters/ Tanks | Move all eligible donors to a single canister or tank. Update cryo records and log books. |
| Separate Sperm and Egg Bank Donor Binders | Particularly review shipping records to ensure that when donor tissue is received it is located in the correct binder, tank, and canister. |
| Take the FDA Survey in the ART Compass app and assign survey to staff | Review competency results and assign any needed remediation. Download the free ART Compass app Apple App Store: https://itunes.apple.com/us/app/art-compass/id1442048939?mt=8 Google Play Store: https://play.google.com/store/apps/details?id=com.artproficiencyapp |
| Update FDA Cryopreserved tissues eligibility forms | Copy language directly from HCTP and replace out of date language. |
| Review Summary of Records forms | Update out of date language by reviewing FDA Warning Letters (search for “fertility”). |
| Review Donor Risk Checklist / Questionnaire for updated risk questions | Update out-of-date language by reviewing FDA Warning Letters (search for “fertility”). |
| Review Requisitions for tissue type – anonymous, directed donor, and for future GC | Correct sperm freezing, egg cryo, and IVF requisitions so that IVF Lab can put an accurate FDA Cover sheet or sticker with each cryo record. |
| Review FDA eligibility form or stickers with each cryopreserved tissue by randomly selecting 10 GC transfers, 10 Egg Donor Embryos, and 10 Sperm Donor Embryos | Hold a staff meeting to ensure that each FDA eligibility status’ are used correctly. Goal of 100% compliance. Document staff/ lab meeting. |
| Review one full binder of sperm records and one full binder of embryo records for presence of FDA Eligibility sheets or stickers. If missing more than 3 per binder review all binders. | Replace or correct any FDA Eligibility sheets in each binder. |
| Read and sign off on all FDA related policies and procedures | Document each person for each Policy and Procedure. Assign them to staff and records annual sign offs in the ARTC Document control system. |
| Read FDA Warning Letters for fertility clinics. | Discussion deviations in a lab meeting and document meeting. |
| Review all tests and devices used and check for new FDA approved products. | Still using unapproved tests or devices? Are there any new tests of devices that can replace the unapproved ones? |
| Review any FDA reportable adverse donor or device events | Perform a Root Cause Analysis to determine the cause of any incidents. Notify the Laboratory Administrator and the Laboratory Director of the findings. Complete FORM FDA 3500 either in paper format or online at www.fda.gov/medwatch/report.htm |
| IVF Lab Director Responsibilities | Create a folder with evidence of compliance, such as records, reports, or responses to FDA. Make sure to notify FDA of any change in directorship! Update FDA Registration menu. |
| Audit companies that perform any manufacturing step for the IVF laboratory | Check the FDA website for current registration, possible FDA actions against contractors, and patient comments. Take action on any notification of defects or issue with supplies that may affect patient care and document actions. |
| Hold Mock FDA Inspection. | Are you ready for FDA to show up at your IVF Clinic? Review electronic medical records of donor tissue recipients and “provide recommendations” in a mock inspection. |
| September | FDA Audit |
| October | Staff Audit |
| November | Patient Satisfaction and Security |
| December | Space and Supplies |
| January | Preventative Maintenance, Air Quality, and Deep Clean |
| February | Biennial P&P Updates, Review, and Sign Off |
| March | General IVF lab CAP Inspection Preparations |
| April | |
| May | |
| June | |
| July | |
| August | |