Exclusive roundtable insights: Improving the fertility care experience and patient outcomes

LEVY Health hosted our very first Dinner Dialogues, an evening where fertility leaders in the Washington D.C. area came together to discuss what changes can be made to enhance and streamline the experience of fertility care in America.

With valuable input from Reproductive Endocrinologists (REIs), office managers, third party specialists and nurses, we came up with several ways to increase collaboration across the reproductive healthcare ecosystem – to ensure patients get the information and care they need to help them build their families.

Insight 1: Primary care physicians (PCPs) and obstetrician-gynecologists (OB-GYNs) need to be involved in educating patients about fertility

When patients want to start building their families, they are largely unaware of their fertility. And when pregnancy doesn’t happen as quickly as they’d hoped, it’s not always easy to get answers. 

This could change if PCPs and OB-GYNs became more involved in patient education about fertility and the factors that influence reproductive health – especially for patients over 30. Especially since roughly 85% of women turn to their OB-GYN first when struggling to conceive.

By discussing and identifying potential issues early on, healthcare providers can help women make informed decisions about their fertility and pregnancy plans. This ensures that women are aware of any additional steps or treatments that may be necessary to build their family and allows them to plan accordingly.

LEVY’s roundtable highlighted significant gaps in healthcare, particularly in transitions from one specialty to another. While there are experts in various niches of women’s health, there is a clear need for improvement in educating women about their fertility. Early and frequent conversations about fertility should become the standard to better inform and support women.

– Sam Marple, Co-President, Fairfax Donor EggBank

Insight 2: Anti-Müllerian hormone (AMH) testing should be a part of routine health visits

It’s a common misconception that a Pap smear is an indication of reproductive health. While Pap smears detect changes that could be precursors to cervical cancer, they play no role in understanding fertility. 

Anti-Müllerian hormone levels, on the other hand, do. AMH is a measure of a woman’s ovarian reserve. With AMH tests, women can learn approximately how many eggs remain in their ovaries and the number of reproductive years they have left, enabling them to make informed decisions about their future.

Testing AMH levels, identifying conditions that could potentially cause problems conceiving at a later age, and educating patients about reproductive health should therefore become a part of routine health visits.

Insight 3: There needs to be greater collaboration between OB-GYNs and REIs

During our roundtable discussion, it became evident that OB-GYNs may require additional understanding of fertility and a specific approach to kickstart discussions with their patients.

Some healthcare providers may feel uncomfortable discussing fertility as some may not have the necessary information and/or education to provide accurate guidance, most commonly they don’t have enough time.

To bridge this gap, there should be greater collaboration across healthcare providers,, and other stakeholders to improve education and awareness about fertility. For starters, it could involve clinical decision support tools that support healthcare providers in augmenting their judgment, identifying underlying conditions and better triaging patients. This could also involve health systems investing in or partnering with reproductive health specialists to build a stronger referral network and ensure that patients receive the right care.

Highlights from the event

Insight 4: OB-GYNs should be involved in the fertility workup

Currently, an in-depth fertility analysis is only available through fertility clinics, not easily (or financially) accessible to the general population. Women may test a basic panel of hormones through their OB-GYN, but these tests are not detailed enough to uncover the large variety of conditions that can impact female fertility and often are interpreted in the wrong way. It may take months or even years for women to get to the bottom of why they can’t conceive. Which is especially problematic given the age-related fertility decline. Integrating LEVY Health’s software, the LEVY Fertility Code, into OB-GYN practices can streamline the process and increase patient access to fertility testing.When women go through the LEVY Fertility Code, they first complete a detailed Reproductive Health Assessment to provide past medical information & uncover potential factors affecting their fertility. Then, they can visit any Labcorp or Quest site in the country to test a range of reproductive health biomarkers. Equipped with their results, explanations of what they mean for their fertility, and recommended next steps (all within the LEVY Health platform), women can have an informed discussion with their OB-GYN.

OB-GYNs can then support patients who don’t need Assisted Reproductive Treatment (ART) to conceive. If patients do need to visit a fertility clinic or another medical specialist, they can point them in the right direction. 

This approach also addresses the shortage of REIs in the United States. If patients arrive at the initial clinic consultation already pre-screened and triaged for ART, REIs can focus on delivering treatment rather than patient intake. And therefore, have greater capacity to serve more patients.

Insight 5: LEVY Health can assist Advanced Practice Providers (APPs) to handle rising demand

The LEVY FertilIty Code also assists APPs to accommodate increasing patient numbers and help prepare women for fertility treatment. The expenses related to staff are typically a significant portion of a clinic’s budget, and optimizing staff time leads to an enhanced experience for all involved.

The LEVY Fertility Code was developed with leading reproductive care experts according to the latest medical guidelines from the American Society for Reproductive Medicine (ASRM), American College of Obstetricians and Gynecologists (ACOG), and European Society of Human Reproduction and Embryology (ESHRE) and is fully HIPAA-compliant. It takes care of the entire fertility work-up, from collecting patient medical history, ordering and coordinating lab visits, analyzing results, and triaging. 

Integrating the LEVY Fertility Code into more clinics would not only save immense labor costs but also improve patient outcomes by getting women into treatment faster. Saving valuable time on the journey to pregnancy.

The greatest improvement needed is in the continuity of care. Currently, the process is very disjointed: patients see an OB-GYN, get referred to a reproductive endocrinologist (REI), complete their workup, and then often get told they need donor services. This introduces a new team and more steps before they can even begin treatment. If we could streamline this process, moving patients smoothly and quickly through each stage in a collaborative way, it would greatly enhance the patient experience.

– Jen Young (Shady Grove Fertility)

Concluding thoughts

With greater involvement of PCPs and OB-GYNs in patient education and fertility testing, we can drastically increase patient awareness of their fertility. By initiating these conversations and addressing potential issues early on, healthcare providers can help women make informed decisions about their family-building plans and overall reproductive health.

Thank you to everyone who participated in our inaugural event with meaningful insights about improving and streamlining women’s reproductive healthcare. Stay tuned for an announcement on the next Roundtable!