{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T10:39:03Z","timestamp":1785926343810,"version":"3.56.0"},"reference-count":23,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Med Ethics"],"accepted":{"date-parts":[[2024,6,29]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>Infertility patients and patient advocates have long argued for classifying infertility as a disease, in the hopes that this recognition would improve coverage for and access to fertility treatment. However, for many fertility patients, including older women, single women and same-sex couples, infertility does not represent a true disease state. Therefore, while calling infertility a \u2018disease\u2019 may seem politically advantageous, it might actually exclude patients with \u2018social\u2019 or \u2018relational\u2019 infertility from treatment. What is needed is a new conceptual framing of infertility that better reflects the profound significance of being infertile for many people and the importance of addressing infertility in order to improve their lives. In this paper, we argue that the capability approach provides this moral underpinning. The capability approach is concerned with what people are able to <jats:italic>do<\/jats:italic>, and whether they are able to act in a way that is in keeping with their own values and goals. The ability to procreate and build a family is a fundamental capacity and can be a major part of self-fulfilment, regardless of sexual orientation or family arrangement. Since the capability approach asks us to conceive of equality in terms of equal capabilities, it provides a strong ethical impetus for society to help those who cannot conceive on their own to do so with assisted reproduction.<\/jats:p>","DOI":"10.1136\/jme-2024-109877","type":"journal-article","created":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T23:05:18Z","timestamp":1723158318000},"page":"416-419","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Treating infertility as a missing capability, not a disease: a capability approach"],"prefix":"10.1136","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3891-5188","authenticated-orcid":false,"given":"Michelle Jessica","family":"Bayefsky","sequence":"first","affiliation":[{"name":"Obstetrics & Gynecology, NYU Langone Health, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Caplan","sequence":"additional","affiliation":[{"name":"Division of Medical Ethics, NYU Grossman School of Medicine, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,8,8]]},"reference":[{"key":"2025092413540139000_51.6.416.1","unstructured":"World Health Organization . 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AMA backs global health experts in calling infertility a disease [online], Available: https:\/\/www.ama-assn.org\/delivering-care\/public-health\/ama-backs-global-health-experts-calling-infertility-disease [Accessed 15 Jan 2024]."},{"key":"2025092413540139000_51.6.416.5","unstructured":"Resolve: the National Infertility Association . Insurance Coverage by State [online], Available: https:\/\/resolve.org\/learn\/financial-resources-for-family-building\/insurance-coverage\/insurance-coverage-by-state\/ [Accessed 15 Jan 2024]."},{"key":"2025092413540139000_51.6.416.6","first-page":"87","article-title":"Assisted reproduction inequality and marriage equality","volume":"92","author":"Mohapatra","year":"2017","journal-title":"Chi Kent L Rev"},{"key":"2025092413540139000_51.6.416.7","unstructured":"Adashi E . Infertility: A disease by any other name. JAMA Forum 2018. 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Washington, DC: Georgetown University Press, 2004."},{"key":"2025092413540139000_51.6.416.16","doi-asserted-by":"publisher","DOI":"10.1038\/sj.embor.7400435"},{"key":"2025092413540139000_51.6.416.17","unstructured":"Human Fertilisation and Embryology Authority . Family formations in fertility treatment [online], 2018. Available: https:\/\/www.hfea.gov.uk\/media\/3234\/family-formations-in-fertility-treatment-2018.pdf [Accessed 15 Jan 2024]."},{"key":"2025092413540139000_51.6.416.18","unstructured":"Human Fertilisation and Embryology Authority . New figures show how different people are using IVF [online], 2023. Available: https:\/\/www.hfea.gov.uk\/about-us\/news-and-press-releases\/2020\/new-figures-show-how-different-people-are-using-ivf\/#:~:text=The%20report%20also%20highlighted%20that,lowest%20birth%20rates%20at%2017%25 [Accessed 15 Jan 2024]."},{"key":"2025092413540139000_51.6.416.19","unstructured":"Sen A . Equality of what? In: Tanner lectures on human values. 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