How the REI and Embryologist Shortages are Impacting Fertility Access
By: Alexandra Frost
The fertility field is booming, and helping more families than ever before. At the heart of this mission, however, is a problem. There simply aren’t enough skilled professionals who make fertility treatments possible — both embryologists and REI physicians -- to help everyone.
The shortages are only getting worse. A 2023 study found that in order for board-certified REI’s to meet the demand for their services, the “average REI provider would need to oversee approximately 1600 ART cycles each year.”
A 2021 article reported there are 1500 board-certified reproductive endocrinologists in the United States. Similar statistics have been reported in recent surveys, including a 2023 survey sent to ASRM and the Society for Reproductive Endocrinology and Infertility (SREI). That survey reported that 64% of REI providers surveyed are worried about the shortage.
The challenge is just as big on the lab side. Mike Pohleven, US Fertility Business Unit Lead at Organon, says embryologists are “at the heart and soul of the IVF process.” Organon is one of the industry leaders innovating and ideating around solutions to the shortage. “We need to be involved and engaged with those searching for the solutions to the embryology shortage,” Pohleven says.
Here’s why it’s happening, and what’s being done about it.
REIs Join the Call For Support of Embryologists
While there are numerous irreplaceable healthcare professionals in the fertility treatment journey, REIs and embryologists bring essential and specialized knowledge that can make or break a family’s success with the process.
“Embryologists are the unsung heroes working behind the scenes,” says Dr. Brian Levine, founding partner and practice director of CCRM Fertility of New York in New York City. “These are the highly trained experts who care for the eggs, sperm, and embryos every step of the way, literally from the moment they meet. Whether it's prepping the sperm and eggs, performing the actual fertilization, or carefully monitoring embryo growth in the lab, embryologists play a critical role in giving each embryo the best possible shot at becoming a healthy pregnancy.”
In addition, Levine says they handle “delicate” procedures, such as freezing and thawing embryos, which takes “incredible precision” and “deep understanding of embryology.”
“Their skill and judgment are a huge part of what makes these treatments successful. Bottom line: while they may not always be front and center, embryologists are absolutely central to helping patients build their families,” he adds.
Levine shares all of this to underscore the negative impact the embryologist and REI shortages have on patients. “For patients, that can mean longer wait times, having to travel to far-away centers, or, most concerning, missing a critical window for care. That’s especially tough for people with time-sensitive needs, like women with advancing maternal age or those needing fertility preservation ahead of medical treatments like chemo,” Levine says. “And beyond the logistics, this creates a lot of emotional strain. Imagine having to press pause on your future because the right specialist isn’t available.”
Lab bottleneck on top of clinic bottleneck, even in largest cities
Pohleven points back to the COVID-19 pandemic as the beginning of the shortage. “Things really heightened during COVID when the industry saw unprecedented growth for 3 straight years,” he says. “Causes may include increased demand for IVF and ART, limited training programs, lengthy and rigorous training, and an aging workforce.” Levine adds the pandemic brought an already existing problem into “sharper focus”: “One of the first indicators? It was getting harder and harder to hire experienced embryologists, even in major cities where you’d expect a deeper talent pool.”
While some fertility clinics have tried to fill the gaps, Pohleven says they are irreplaceable, and the effects may include “reduced patient access to care, strain on existing embryologists, turnover and burnout, and the potential for lower-quality care.” Research on the embryologist crisis shows high-stakes decision-making, long hours and workload, and emotional burden are a few of the issues contributing to quality of work, which can impact fertility treatment success rates.
Levine shares an example of a clinic even having to hit pause on egg freezing altogether because their small team couldn’t safely handle the demand. “We’ve seen firsthand how clinic capacity issues can affect care, whether it’s delays in embryo transfers or having to limit egg retrievals because the embryology lab just can’t keep up,” he says. “The old model of ‘batching cycles’ is no longer viable, as patients don’t want to wait 3-6 months until they can cycle.”
Ways for the industry and providers to expand IVF access
For Organon, the company remains committed to elevating fertility education and awareness and investing in fertility solutions. “First and foremost, Organon needs to continue delivering exceptional customer service with our customer-facing team and network of specialty pharmacy partners to create a customer experience that enables them to deliver an exceptional patient experience,” Pohleven says. “We are here to assist in the fertility journey by offering patient and product education on Organon’s three brands.”
For the care teams, and others in the industry, access to IVF faces many challenges, which can be addressed by those closer to the patient experience. Levine shares some of the ways in which this could be accomplished by clinics, providers, and other healthcare professionals and companies:
Encouraging career development, training programs, and alternative licensure routes: Numerous roadblocks interfere with the onboarding and hiring process at times, such as bottlenecks with obtaining new licensures, which can take up to 6 months, according to the Association for Advancing Physician and Provider Recruitment. Clinics and other providers may be able to expand training programs and, in collaboration with any licensing agencies, look into enabling a more efficient licensing process.
Improving lab efficiency and automation: While no technological development can replace human expertise and precision in this field as of now, companies operating laboratories can move towards improving lab efficiency and automating other processes that can free specialists up to do the work only they can do. Levine says, “What happens under the microscope directly impacts patient outcomes. As our field grows, so does our responsibility to support the professionals making it all possible. Without them, our ability to provide timely, high-quality care simply falls apart.”
Addressing mental health and burnout: Though the rate is improving, burnout still affects around half of physicians. Levine shares part of the issue is the “nature of the job.” “Being an embryologist requires incredible precision and focus — often over long hours, weekends, holidays — without the kind of compensation or structural support that matches the intensity of the role. It’s no surprise we’re seeing early burnout and attrition, especially among younger professionals. Again, it’s not unlike what’s happening in endocrinology.”
Finding a solution to the problem quickly, and “seriously investing in the next generation” is essential — Levine says, “These aren’t just scheduling problems, they’re real risks to people’s health, hopes, and quality of life.”
This News Digest Story is paid featured content. The advertiser has had editorial input and control over its creation. However, the views and opinions expressed in this article do not necessarily represent the views of Inside Reproductive Health. The sponsorship of this content does not imply an endorsement by Inside Reproductive Health.
