,,iv #aag? ,,congress #a/ ,session ,h4 ,,res4 #cch ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,april #bj1 #bjba,ms4 ,wass]man ,s*ultz 7= h]self & ,mr4 ,cr5%aw7 submitt$ ! foll[+ resolution2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce ,,resolution ,recogniz+ t inf]tility is a widespread problem t affects populations ( div]se ages1 races1 e?nicities1 & g5d]s4 ,:]eas inf]tility is a disease recogniz$ by ! ,_w ,heal? ,organization & ! ,am]ican ,m$ical ,association1 &1 accord+ to ! ,national ,in/itutes ( ,heal? 7,,nih71 a t]m us$ to describe ! inability ( a c\ple to get pregnant or ! inability ( a woman to c>ry a pregnancy to t]m1 & def9$ cl9ically z n be+ able to a*ieve pregnancy aft] #a ye> ( hav+ regul>1 unprotect$ int]c\rse1 or aft] #f mon?s if ! woman is old] ?an #ce ye>s ( age2 ,:]eas inf]tility may also be det]m9$ bas$ on a p]son's inability to reproduce ei!r z a s+le individual or ) _! p>tn] )\t m$ical int]v5tion1 or det]m9$ by a lic5s$ physician's f9d+s bas$ on a pati5t's m$ical1 sexual1 & reproductive hi/ory1 age1 physical f9d+s1 or diagno/ic te/+2 ,:]eas reproductive & inf]tility issues affect a sub/antial numb] ( ,am]icans1 & data f ! ,c5t]s = ,disease ,control & ,prev5tion %[ t ab\t #ab p]c5t ( wom5 9 ! ,unit$ ,/ates h difficulty gett+ pregnant or /ay+ pregnant & #i p]c5t ( m5 exp]i5ce inf]tility2 ,:]eas1 accord+ to ! ,,nih1 !re are cle> racial & e?nic disp>ities 9 inf]tility preval5ce1 & su* racial disp>ities are n unique to reproductive issues & un=tunately widely p]vade ! ,unit$ ,/ates heal? c>e sy/em2 ,:]eas ,blacks1 ,hispanics1 ,a%k5azi ,jews1 ,am]ican ,indians1 ,alaska ,natives1 ,native ,hawaiians & ,pacific ,isl&]s1 ,ea/ ,asians1 ,indians & ,paki/anis f ! ,punjab region1 & p]sons ( ,c>ibbean1 ,m$it]ranean1 ,fr5* ,canadian1 or ,middle ,ea/]n ance/ry suff] f disproportionately high] rates ( c]ta9 diseases & gynecological1 endocr9e1 & autoimmune disord]s1 t may contribute to high] rates ( inf]tility among ^! populations2 ,:]eas ,hispanics1 ,am]ican ,indians1 & ,alaska ,natives h exp]i5c$ ! mo/ significant *ange1 ) f]tility 9 ,hispanics dropp+ #ah4gh p]c5t f #bjjh to #bjaf1 & f]tility 9 ,am]ican ,indians & ,alaska ,natives dropp+ #ae4a p]c5t dur+ ! same p]iod2 ,:]eas vet]ans :o h suff]$ traumatic physical injury1 po/-traumatic /ress disord]1 or o!r physical or m5tal ailm5ts c & d suff] f inf]tility1 & data f ! ,dep>tm5t ( ,vet]ans ,affairs %[ t #ae4h p]c5t ( female vet]ans report$ inf]tility 7#d p]c5t high] ?an ! female av]age7 & #ac4h p]c5t ( male vet]ans report$ inf]tility 7#d4h p]c5t high] ?an ! male av]age72 ,:]eas inf]tility c be caus$ by g5etic conditions1 bir? defects1 injury1 environm5tal factors1 m$ical treatm5ts1 m$ications1 gamete ag+ & decreas$ conc5tration1 viruses1 disord]s1 or o!r diseases1 or may be idiopa?ic2 ,:]eas common causes ( inf]tility are ovulation disord]s1 ut]9e or c]vical abnormalities1 fallopian tube damage or blockage1 endometriosis1 prim>y ov>ian insuffici5cy 7e>ly m5opause71 pelvic adhesions1 canc] & its treatm5t1 abnormal sp]m production or function1 problems ) ! deliv]y ( sp]m1 & ov]exposure to c]ta9 environm5tal factors2 ,:]eas inf]tility disproportionately affects individuals ) p>ticul> heal? complications1 su* z canc]1 because pati5ts mu/ und]go treatm5ts su* z *emo!rapy1 radiation !rapy1 hormone !rapy1 or surg]y t are likely to h>m ! reproductive sy/em1 organs1 or gametes1 & f]tility pres]vation becomes m$ically necess>y2 ,:]eas ! risk ( inf]tility is increas$ by age1 smok+1 excessive alcohol use1 extreme weight ga9 or loss1 excessive physical or emotional /ress1 or o!r conditions l diabetes t result 9 am5orrhea 7abs5t p]iods71 use ( m>ijuana1 exposure to c]ta9 m$ications1 & exposure to environm5tal tox9s2 ,:]eas inf]tility is a major life ev5t :i* may br+ ab\t social & psy*ological problems1 su* z ang]1 depression1 anxiety1 m>ital problems1 sexual dysfunction1 social isolation1 /igma1 s5se ( loss1 & dim9i%$ self-e/eem2 ,:]eas a ,h>v>d ,univ]sity /udy %[s t 9 ab\t #a 9 #c cases1 bo? p>tn]s h _h physiological problems dur+ & aft] exp]i5c+ inf]tility2 ,:]eas regulatory disp>ities & lack ( access to heal? c>e speciali/s cause inequities 9 ! f9ancial burd5 c>ri$ by p :o seek diagno/ic te/+ & treatm5t = inf]tility1 pres5t+ a b>ri] to heal? c>e & bett] heal? outcomes1 & ^! factors disproportionately impact m9ority & l[] income individuals2 & ,:]eas #cg p]c5t ( ,:ite ,am]icans report !y h und]gone f]tility treatm5t or "k someone :o has1 :i* is significantly high] ?an #bb p]c5t ( ,black ,am]icans & #bf p]c5t ( ,hispanic ,am]icans :o report ! same3 ,n[1 !re=e1 be x ,t ! ,h\se ( ,repres5tatives recognizes-- 7#a7 t inf]tility is a disease2 7#b7 t ! ,unit$ ,/ates ,gov]nm5t has a responsibility to help exam9e1 create1 & implem5t solutions to address & alleviate ! problems associat$ ) ! disease2 7#c7 ! gr[+ racial1 e?nic1 & income-bas$ disp>ities associat$ ) access to education & aw>5ess1 scre5+s1 treatm5ts1 & proc$ures2 7#d7 ! importance ( rais+ aw>5ess & improv+ education ab\t inf]tility1 disabl+ side effects1 associat$ m5tal heal? issues1 & pres]vation options t w help p make educat$ decisions ab\t family build+1 :e!r ?r\gh m$ical int]v5tion1 adoption1 or decid+ n to h *ildr52 7#e7 ! ne$ = enc\rag+ rese>* t w improve inf]tility treatm5ts & outcomes & f]tility pres]vation te*nologies2 7#f7 ! importance ( necess>y ov]sight ( gov]nm5t ag5cies involv$ 9 rese>* & data collection relat$ to inf]tility preval5ce1 treatm5ts1 outcomes1 & f]tility pres]vation te*nologies1 & work+ to ensure ! consi/5cy ( data & in=mation-%>+ across gov]nm5t ag5cies2 & 7#g7 a duty ( ! ,f$]al ,gov]nm5t to ensure ! availability ( inf]tility-relat$ s]vices to all individuals & families )\t b>ri]s su* z access1 co/1 & cov]age4