Received April 22, 2023
Accepted October 21, 2023

Objective Patients face challenges accessing fertility treatment due to barriers such as financial burdens, delayed referral to Reproductive Endocrinologists (REI), low medical literacy, language barriers and numerous other health disparities. Medicaid in New York offers coverage for office visits, blood tests, hysterosalpingograms (HSGs), and pelvic ultrasounds for infertility. The aim of this study is to delineate the characteristics of this underserved patient population and determine their ability to complete the initial fertility workup. Methods This was a retrospective study of all patients seeking fertility care at a single resident/fellow REI clinic in New York from September 2020 – January 2022. Results During the study period, 87 patients (avg age = 35.2 y) sought care at the resident/fellow clinic over 126 appointments. 66.7% of patients attended their scheduled appointment. The majority of patients had Medicaid insurance and most primary languages spoken included English (70.1%), Spanish (21.8%), and Bengali (3.4%). Documented Race was comprised of mostly Other (46%), African American (21.8%), Asian (17.2%), and White (11.5%). The majority of patients completed a lab workup (70-80%). Fewer patients underwent a scheduled HSG (59.8%). A smaller proportion of patients’ partners completed a semen analysis (SA) (27.6%). Overall, there was a significant difference in the ability to complete the initial infertility workup (lab tests vs. HSG vs. SA) across all groups regardless of age, insurance type, primary language spoken, race and ethnicity (p<0.05). Conclusion Completing the fertility workup, particularly the male partner workup and imaging studies, can present challenges for underserved patients with infertility.