Definition of infertility: a committee opinion (2023) (2025)

Definition of infertility: a committee opinion (2023)


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‘‘Infertility’’ is a disease, condition, or status characterized by any of the following:

  • The inability to achieve a successfulpregnancy based on a patient’smedical, sexual, and reproductivehistory, age, physical findings, diagnostictesting, or any combinationof those factors.
  • The need for medical intervention, including,but not limited to, the use ofdonor gametes or donor embryos inorder to achieve a successful pregnancyeither as an individual orwith a partner.
  • In patients having regular, unprotectedintercourse and without anyknown etiology for either partnersuggestive of impaired reproductiveability, evaluation should be initiatedat 12 months when the femalepartner is under 35 years of ageand at 6 months when the femalepartner is 35 years of age or older.

Nothing in this definition shall be used to deny or delay treatment to any individual, regardless of relationship status or sexual orientation.

Acknowledgments: This report was developed under the direction of the Practice Committee of the American Society for Reproductive Medicine as a service to its members and other practicing clinicians. Although this document reflects appropriate management of a problem encountered in the practice of
reproductive medicine, it is not intended to be the only approved standard of practice or to dictate an exclusive course of treatment. Other plans of management may be appropriate, taking into account the needs of the individual patient, available resources, and institutional or clinical practice limitations.
The Practice Committee and the Board of Directors of the American Society for Reproductive Medicine have approved this report.

The following members of the ASRM Practice Committee participated in the development of this document: Clarisa Gracia, M.D., M.S.C.E.; Jacob Anderson; Paula Amato, M.D.; Rebecca Flyckt, M.D.; Karl Hansen, M.D., Ph.D.; Micah Hill, D.O.; Sangita Jindal, Ph.D.; Suleena Kalra, M.D., MSCE; Tarun Jain, M.D.; Bruce Pier, M.D.; Michael Thomas, M.D.; Jared Robins, M.D.; Chevis N Shannon, Dr.Ph., M.B.A., M.P.H.; Anne Steiner, M.D., M.P.H.; Cigdem Tanrikut, M.D.; and Belinda Yauger, M.D. All Committee members disclosed commercial and financial relationships with manufacturers or distributors of goods or services used to treat patients. Members of the committee who were found to have conflicts of interest based on the relationships disclosed did not participate in the discussion or development of this document.

Practice Documents

ASRM Practice Documents have been developed to assist physicians with clinical decisions regarding the care of their patients.

Definition of infertility: a committee opinion (2023) (1)

Evidence-based guideline: Premature Ovarian Insufficiency (2024)

This guideline on premature ovarian insufficiency (POI) offers best practice advice on the care of women with POI.

View the Joint Committee Document

Definition of infertility: a committee opinion (2023) (2)

Gamete and embryo donation guidance (2024)

Explore the latest guidelines for evaluating sperm, oocyte, and embryo donors and recipients. Includes FDA, CDC, and ASRM standards for optimal safety and outcomes.

View the Committee Document

Definition of infertility: a committee opinion (2023) (3)

Maternal cardiovascular morbidity and mortality associated with pregnancy in individuals with Turner syndrome: a committee opinion (2024)

In individuals with Turner syndrome, the risk of death from aortic dissection or rupture during pregnancy may be as high as 1%, and it is unclear whether this risk persists during the postpartum period owing to pregnancy-related aortic changes.

View the Committee Opinion

Definition of infertility: a committee opinion (2023) (4)

Fertility drugs and cancer: a guideline (2024)

Methodological limitations in studying the association between the use of fertility drugs and cancer include the inherent increased risk of cancer in women who never conceive, the increased risk of cancer because of factors (endometriosis and unopposed estrogen) associated with infertility, the low incidence of most of these cancers, and that the diagnosis of cancer is typically several years after fertility drug use.

View the Committee Guideline

View all Practice Committee Documents

More Resources

Definition of infertility: a committee opinion (2023) (5)

ASRM Practice Documents

These guidelines have been developed by the ASRM Practice Committee to assist physicians with clinical decisions regarding the care of their patients.

View ASRM Practice Documents

Definition of infertility: a committee opinion (2023) (6)

ASRM Academy on the Go

ASRM MAC Tool 2021

The ASRM Müllerian Anomaly Classification 2021 (MAC2021) includes cervical and vaginal anomalies and standardize terminology within an interactive tool format.

View the MAC Tool

Definition of infertility: a committee opinion (2023) (7)

Practice Guidance

The Coding Corner Q & A is a list of previously submitted and answered questions from ASRM members about coding. Answers are available to ASRM Members only.

Definition of infertility: a committee opinion (2023) (8)

Practice Guidance

EMR Shared Phrases/Template Library

This resource includes phrases shared by ASRM physician members to provide a template for individuals to create their own EMR phrases.

View the library

Definition of infertility: a committee opinion (2023) (9)

ASRM Ethics Opinions

Ethics Committee Reports are drafted by the members of the ASRM Ethics Committee on the tough ethical dilemmas of reproductive medicine.

View ASRM Ethics Opinions

Definition of infertility: a committee opinion (2023) (10)

Practice Guidance

COVID-19 Resources

A compendium of ASRM resources concerning the Novel Corona virus (SARS-COV-2) and COVID-19.

View the resources

Definition of infertility: a committee opinion (2023) (11)

Patient Resources

ReproductiveFacts.org provides a wide range of information related to reproductive health and infertility through patient education fact sheets, infographics, videos, and other resources.

View Website

Topic Resources

View more on the topic of infertility

Definition of infertility: a committee opinion (2023) (12)

National Infertility Awareness Week

April 19-25, 2026, is National Infertility Awareness Week (NIAW)!

View the NIAW Toolkit

Definition of infertility: a committee opinion (2023) (13)

Empathy in Action: Strengthening the Patient-Provider Connection

Dr. Tara Harding discusses how healthcare providers can foster empathy, trust, and patient-centered care to improve women's health outcomes. View the ASRMed Talk Video

Definition of infertility: a committee opinion (2023) (14)

Fertility and Sterility On Air - TOC: Feb 2025

Explore the latest research in reproductive medicine, from IVF risks to IVM advancements, POI implications, and REI fellowship insights in this episode of F&S On Air. Listen to the Episode

Definition of infertility: a committee opinion (2023) (15)

Evidence-based guideline: Premature Ovarian Insufficiency (2024)

This guideline on premature ovarian insufficiency (POI) offers best practice advice on the care of women with POI. View the Joint Committee Document

Definition of infertility: a committee opinion (2023) (16)

Use of preimplantation genetic testing for monogenic adult-onset conditions: an Ethics Committee opinion (2024)

Preimplantation genetic testing for adult-onset monogenic diseases is ethically allowed when fully penetrant or conferring disease predisposition. View the Committee Opinion

Definition of infertility: a committee opinion (2023) (17)

Appropriate Use of Modifier -25

Is Modifier -25 appropriate in the monitoring cycle when an ultrasound View the Answer

Definition of infertility: a committee opinion (2023) (18)

Billing for E/M Visits

When billing Evaluation & Management (E/M) visits based on medical decision-making, would we View the Answer

Definition of infertility: a committee opinion (2023) (19)

When to use code Z31.83

When a patient is completing an approved fertility cycle, is it necessary View the Answer

Definition of infertility: a committee opinion (2023) (20)

Timed Intercourse Cycle Codes

Is it appropriate to utilize codes N97.8 or View the Answer

Definition of infertility: a committee opinion (2023) (21)

The use of preimplantation genetic testing for aneuploidy: a committee opinion (2024)

PGT-A use in the U.S. is rising, but its value as a routine IVF screening test is unclear, with mixed results from various studies. View the Committee Opinion

Definition of infertility: a committee opinion (2023) (22)

Fertility Support and AI: Help or Hinderance

Discover how fertility apps impact patient care and nursing staff. Explore the balance between tech and human touch in complex fertility treatments View the ASRMed Talk Video

Definition of infertility: a committee opinion (2023) (23)

HyCoSy and CPT 74740

When Office HSG/HyCoSy is performed but no x-ray/fluoroscopic imaging is performed, only ultrasound is done, is it appropriate to bill CPT code 74740? View the Answer

Definition of infertility: a committee opinion (2023) (24)

Subclinical hypothyroidism in the infertile female population: a guideline (2024)

This guideline reviews the risks and benefits of treating subclinical hypothyroidism in female patients with a history of infertility and miscarriage. View the Committee Guideline

Definition of infertility: a committee opinion (2023) (25)

Tobacco or marijuana use and infertility: a committee opinion (2023)

In the United States, approximately 21% of adults report some form of tobacco use, although 18% report marijuana use. View Committee Opinion

Definition of infertility: a committee opinion (2023) (26)

Journal Club Global: The future of REI Fellowship training: debating opportunities and threats

This exciting collaboration discusses the controversy and future directions for the field of Reproductive Endocrinology and Infertility medicine. View the Video

Definition of infertility: a committee opinion (2023) (27)

Journal Club Global: Infertility and Subclinical Hypothyroidism

The impact of treating SCH on fertility, obstetric outcomes, and offspring neurocognitive development is debated in the literature. View the Video

Definition of infertility: a committee opinion (2023) (28)

Ethical obligations in fertility treatment when intimate partners withhold information from each other: an Ethics Committee opinion (2024)

Clinicians should encourage disclosure between intimate partners but should maintain confidentiality where there is no harm to the partner and/or offspring. View the Committee Opinion

Definition of infertility: a committee opinion (2023) (29)

Ethical considerations for telemedical delivery of fertility care: an Ethics Committee opinion (2024)

Telemedicine has the potential to increase access to and decrease the cost of care. View the Committee Opinion

Definition of infertility: a committee opinion (2023) (30)

Definition of infertility: a committee opinion (2023)

‘‘Infertility’’ is a disease, condition, or status characterized by several factors. View the Committee Opinion

Definition of infertility: a committee opinion (2023) (31)

Diagnostic evaluation of sexual dysfunction in the male partner in the setting of infertility: a committee opinion (2023)

It is the responsibility of the clinician to assess for erectile dysfunction, ejaculatory dysfunction, or diminished libido in men presenting for infertility. View the Committee Opinion

Definition of infertility: a committee opinion (2023) (32)

Journal Club Global - Actualización en la suplementación con progesterona en fase lútea para transferencias de embriones congelados

Efectividad del rescate de progesterona en mujeres que presentan niveles bajos de progesterona circulante alrededor del día de la transferencia de embriones View the Video

Definition of infertility: a committee opinion (2023) (33)

Post Vasectomy Infertility

If a husband has had a vasectomy, does the sterilization code apply to the wife's visits? View the Answer

Definition of infertility: a committee opinion (2023) (34)

Pregnancy Of Uncertain Viability Ultrasound

My staff is telling me that I am getting reimbursed for the first sonogram and OB visit (using ICD 10 code for pregnancy of uncertain viability – O36.80X0. View the Answer

Definition of infertility: a committee opinion (2023) (35)

Pregnancy Ultrasound

Our practice does routine ultrasounds (sac check- 76817) at the end of an IVF cycle and bill with a diagnosis code O09.081, pregnancy resulting from ART. View the Answer

Definition of infertility: a committee opinion (2023) (36)

Psychological Evaluation

Many REs require patients (and their spouses/partners) who are considering using donor gametes to see an infertility counselor first. View the Answer

Definition of infertility: a committee opinion (2023) (37)

Self-referred New Patient

A patient self-refers to our physician for an initial new patient consultation instead of referred by another physician, how do we code for the consult? View the Answer

Definition of infertility: a committee opinion (2023) (38)

Surgery Coding

I took the ASRM coding course, and in that course, coding for bilateral neosalpingostomies was coded using only a dx of N70.11 (hydrosalpinx). View the Answer

Definition of infertility: a committee opinion (2023) (39)

Telephone Consult

Does a physician need to speak directly to a patient to code for a telephone consult (99371-99373) or can a staff member relay physician notes to patients? View the Answer

Definition of infertility: a committee opinion (2023) (40)

Testing With No History of Infertility

What diagnosis codes should providers submit to insurance carriers while trying to evaluate fertility issues? View the Answer

Definition of infertility: a committee opinion (2023) (41)

Infertility Consult

Does ASRM have any examples of evaluation and management documentation for patients being seen for an initial infertility evaluation? View the Answer

Definition of infertility: a committee opinion (2023) (42)

Infertility Consult by Nurse

What code is used for a nurse practitioner seeing a fertility patient for the first time? View the Answer

Definition of infertility: a committee opinion (2023) (43)

Initial Visit for Infertility With No Mandated Coverage

What code would be appropriate for an initial visit for infertility? View the Answer

Definition of infertility: a committee opinion (2023) (44)

IUI or IVF

Should other ovarian dysfunction (diagnosis code E28.8) or unspecified ovarian dysfunction (diagnosis code E28.9) can be used for an IUI or an IVF cycle View the Answer

Definition of infertility: a committee opinion (2023) (45)

Monitoring E&M

Our group would like to know if others are billing an evaluation and management code for ultrasound and blood draw visits? View the Answer

Definition of infertility: a committee opinion (2023) (46)

New vs Established Patient

How soon can you bill as a new infertility patient? View the Answer

Definition of infertility: a committee opinion (2023) (47)

General E&M Consult

Recently we have received a “re-code” on a new patient (we billed a 99203 and the insurance re-coded it to a 99213). View the Answer

Definition of infertility: a committee opinion (2023) (48)

Hysteroscopy Recurrent Implantation Failure

What is the appropriate ICD-10 code for recurrent implantation failure? View the Answer

Definition of infertility: a committee opinion (2023) (49)

D&C Under Ultrasound Guidance

What are the CPT codes and ICD-10 codes for coding a surgical case for a patient with history of Stage B adenocarcinoma of the cervix ... View the Answer

Definition of infertility: a committee opinion (2023) (50)

Diagnostic Testing of an Infertile Couple

The Z31.41 is or is not the correct code to use for diagnostic testing of an infertile couple? And If so can if be used as the primary and only code? View the Answer

Definition of infertility: a committee opinion (2023) (51)

Diagnosis of Infertility for IVF Procedure

How important is it to have accurate documentation of the type of infertility diagnosis for IVF procedures? View the Answer

Definition of infertility: a committee opinion (2023) (52)

Blood Draws

If a patient comes in only for a blood draw (venipuncture) and is seen only by the lab technician (not an MD, PA, or NP), may we bill for a (minimal) office visit? View the Answer

Definition of infertility: a committee opinion (2023) (53)

Blood Tests

Patients are requesting to have lab work drawn from the female patient moved to the males account due to the female fertility coverage being maxed out. View the Answer

Definition of infertility: a committee opinion (2023) (54)

Male Infertility

A summary of common codes for Male Infertility compiled by the ASRM Coding Committee. View the Coding Summary

Definition of infertility: a committee opinion (2023) (55)

Fertility evaluation of infertile women: a committee opinion (2021)

Diagnostic evaluation for infertility in women should be conducted in a systematic, expeditious, and cost-effective manner. View the Committee Opinion

Definition of infertility: a committee opinion (2023) (56)

ASRM müllerian anomalies classification 2021

The Task Force set goals for a new classification and chose to base it on the iconic AFS classification from 1988 because of its simplicity and recognizability. View the Committee Opinion

Definition of infertility: a committee opinion (2023) (57)

Moving innovation to practice: an Ethics Committee opinion (2021)

The introduction of new strategies, tests, and procedures into clinical practice raises challenging ethical issues. View the Committee Opinion

Definition of infertility: a committee opinion (2023) (58)

Intracytoplasmic sperm injection (ICSI) for non–male factor indications: a committee opinion (2020)

Intracytoplasmic sperm injection is frequently used in combination with assisted reproductive technologies. View the Committee Document

Definition of infertility: a committee opinion (2023) (59)

Use of exogenous gonadotropins for ovulation induction in anovulatory women: a committee opinion (2020)

Pretreatment evaluation, indications, treatment regimens, and complications of gonadotropin treatment. View the Committee Opinion

Definition of infertility: a committee opinion (2023) (60)

Reproductive and hormonal considerations in women at increased risk for hereditary gynecologic cancers: Society of Gynecologic Oncology and American Society for Reproductive Medicine Evidence-Based Review (2019)

Providers who care for women at risk for hereditary gynecologic cancers must consider the impact of these conditions. View the Joint Statement

Definition of infertility: a committee opinion (2023) (61)

Guidance for Providers Caring for Women and Men Of Reproductive Age with Possible Zika Virus Exposure (Updated 2019)

This ASRM guidance specifically addresses Zika virus infection issues and concerns of individuals undergoing assisted reproductive technologies (ART). View the Guideline

Definition of infertility: a committee opinion (2023) (62)

Fertility treatment when the prognosis is very poor or futile: an Ethics Committee opinion (2019)

The Ethics Committee recommends that in vitro fertilization (IVF) centers develop patient-centered policies regarding requests for futile treatment. View the Committee Opinion

Definition of infertility: a committee opinion (2023) (63)

American Society for Reproductive Medicine position statement on uterus transplantation: a committee opinion (2018)

Following the birth of the first child from a transplanted uterus in Gothenburg, Sweden, in 2014, other centers worldwide have produced scientific reports. View the Committee Opinion

Definition of infertility: a committee opinion (2023) (64)

Child-rearing ability and the provision of fertility services: an Ethics Committee opinion (2017)

Fertility programs may withhold services on the basis that patients will be unable to provide minimally adequate or safe care for offspring. View the Committee Opinion

Definition of infertility: a committee opinion (2023) (65)

The International Glossary on Infertility and Fertility Care, 2017†‡§ (2017)

Terms and definitions currently used infertility care, infertility and medically assisted reproduction (MAR) can have different meanings that are dependent upon the setting, their usage in research or clinical interventions, or among diverse populations.
View the Committee Joint Guideline

Definition of infertility: a committee opinion (2023) (66)

Removal of myomas in asymptomatic patients to improve fertility and/or reduce miscarriage rate: a guideline (2017)

This review evaluates if uterine myomas impact likelihood of pregnancy and pregnancy loss, and if myomectomy influences pregnancy outcomes. View the Guideline

Definition of infertility: a committee opinion (2023) (67)

Improving the Reporting of Clinical Trials of Infertility Treatments (IMPRINT): modifying the CONSORT statement (2014)

Clinical trials testing infertility treatments often do not report on the major outcomes of interest to patients and clinicians and the public. View the Guideline

Definition of infertility: a committee opinion (2023) (68)

Endometriosis and infertility: a committee opinion (2012)

Women with endometriosis typically present with pelvic pain, infertility, or an adnexal mass, and may require surgery. View the Committee Opinion

Definition of infertility: a committee opinion (2023) (2025)

References

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