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Policy Blog: Five Questions: CDC Action Plan for the Detection, Prevention and Management of Infertility

Lawrence Ross, MDLawrence Ross, MD
August 8, 2014

In July, the Centers for Disease Control and Prevention released its long-awaited National Public Health Action Plan for the Detection, Prevention and Management of Infertility. The plan was developed over seven years in conjunction with infertility experts and examines the scope of activities at the CDC that relate to this important men's health topic. Representatives from the AUA and the American Society for Reproductive Medicine (ASRM) participated in activities that informed the plan. We recently sat down with former AUA President Dr. Lawrence S. Ross to discuss the plan and his involvement in its development.

Q: Why did the CDC pursue this initiative?

The CDC's mandate is to protect the health of our citizens. CDC has long been interested in women's reproductive health and the disease processes that impact pregnancy and child bearing (sexually transmitted diseases [STDs], hormonal disorders, genetic disorders, menopause, birth control, cancer and its treatment). Women have actively pressed their elected federal representatives questioning why health insurance treats infertility as a "lifestyle issue" and not as a disease process.

Q: How did the AUA get involved and in what capacity?

In 2006, while serving as AUA President, I was invited to give the Bruce Stewart Lecture at the annual meeting of the American Society of Reproductive Medicine (ASRM). This talk is sponsored by the AUA to honor the memory of Dr. Stewart, who was the first urologist to serve as ASRM president. My presentation was geared to educating reproductive endocrinologists (OB/Gyn specialists who treat infertile women) about the role of male reproductive disorders and the need to have urologic evaluation of all male partners of infertile couples. The director of the CDC Section of Women's Health and Reproduction heard my presentation and invited me to the CDC to give a series of talks to their scientific staff. In 2008, the CDC invited stakeholders (physicians, patients, industry, lay groups) with interest in infertility to a two-day meeting on the subject. Subsequently, a group of physicians and scientists began the process to develop the National Public Action Plan. I was invited to represent urology. The plan was completed in 2012, was reviewed by all stakeholders, CDC staff, and other national agencies, a process that required almost two years to complete. The Plan was released in 2014 and is available on the CDC website.

Q: Why is this initiative important to AUA members?

The National Action Plan elevates the importance of male reproductive disorders and the diseases that impact infertility to equal status with those of women. We are moving to what we hope will be the establishment of a Section of Men's Health and Reproduction at the CDC to stand beside the section for women which has existed for more than 30 years. Our efforts have led to a growing relationship with and access to the highest leadership at CDC.

Q: How does this report impact urology practice?

Data gathered and reported by the CDC frequently informs decisions at many levels of the federal government (NIH grants, public health programs). Private institutions supporting research efforts may consider CDC findings in their deliberations. Patients and patient support groups will use the National Action Plan to push for insurance coverage for treatment of infertility and the diseases related to it.

Q: Does the CDC have additional plans for similar activity in the urology space?

Urology related issues are growing at the CDC. I recently provided consultation for their publication: "Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs, Recommendations and Reports," April 25, 2014 / 63(RR04);1-29. On August 19, the CDC will be hosting a Grand Rounds on Infertility.

The CDC has interest in the rapidly growing use and potential abuse of testosterone supplements. They have consulted with a number of AUA members as they plan a study to determine the public health safety and risks of testosterone use.

Read more about the National Action Plan.

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