By Janet Choi, MD, Chief Medical Officer
ASRM is one of my favorite annual gatherings because it’s a chance to reconnect with colleagues and friends, exchange ideas, and learn about the latest research shaping the evolution of reproductive endocrinology and infertility care. This year’s conference in San Antonio was especially meaningful, as I co-authored a featured abstract exploring how a specialized Medical Advisory Board (MAB), working in collaboration with a benefit provider, can help promote evidence-based, best-practice fertility care—specifically by advising on gonadotropin/IUI criteria to support safety and optimized patient selection.
Working alongside some of our Progyny network providers—including lead author Keri Bergin, MD—as well as Reproductive Medicine Associates of New York leaders including Alan Copperman, MD, and research lead and coordinator Joseph Lee, we examined how increased clinical review of IUI treatment requests might better optimize treatment selection and outcomes by reducing unnecessary risks.
Why does this matter?
Multiple-gestation pregnancies—more common when gonadotropins are used—carry disproportionate risks, including higher rates of pregnancy loss, preterm delivery, and extended NICU stays. These are outcomes every clinician and patient hopes to avoid.
That’s why applying a thoughtful, medically grounded review process before approving gonadotropin/IUI cycles is so important. In our retrospective, two-year cohort study, our MAB of reproductive endocrinologists advised on shaping UM policy using ASRM and other peer-reviewed guidelines to ensure appropriate patient selection for requested treatment benefits. The actual reviews were conducted by a dedicated team of network REI providers and fertility nurses who apply these evidence-based criteria when evaluating requests. Gonadotropins can be an excellent option for many individuals on their fertility journey, but, as with any treatment, it’s essential to identify who is most likely to benefit and who may face unnecessary risk.
Our findings were encouraging: refining the criteria for gonadotropin/IUI significantly reduced high-risk multiple-gestation pregnancies without compromising success rates. The multiple-gestation rate dropped from 10% of IUI pregnancies to 0%, while clinical pregnancy rates remained essentially unchanged.
You can watch our presentation video, where Dr. Bergin and I walk through our approach and findings in detail:
The takeaway is clear: careful, data-driven patient selection can meaningfully improve safety in fertility care. Organizations seeking to reduce multiple gestation pregnancies have a real opportunity to update policies and selection criteria in ways that support patients while maintaining optimal patient outcomes.
At Progyny, we deeply value the clinical nuances that shape each patient’s family building path. Our role as a benefit provider is not to dictate care, but to ensure that requested covered treatments meet standards of clinical appropriateness—always with the goal of helping individuals receive the right care at the right time, in the safest and most supportive way possible. That commitment drives our investment in strong clinical partnerships and ongoing research that elevates the field and enhances the patient experience.
I’m proud that Progyny is contributing meaningful, current data on this aspect of fertility treatment and that we were able to share these insights with the ASRM community. We had energizing conversations at the conference and received positive feedback from colleagues equally committed to improving reproductive health. Ultimately, our collective goal at ASRM remains the same: to help every intended parent have the healthiest possible path to a full-term baby.