Jeffery, J

Abstract Introduction Infertility insurance benefits remain a key concern for individuals pursuing medical training during peak reproductive years. While urologists play a central role in managing male infertility, the availability and visibility of fertility benefits during urology residency remain poorly characterized. Delays in family building are common among male trainees, often paralleling those of their partners. By the time individuals pursue fertility care, partners may already be within or approaching advanced reproductive age. Additionally, male infertility is increasingly recognized as a marker of systemic health conditions, underscoring the importance of adequate evaluation and support. Objective To assess the prevalence, scope, and accessibility of infertility treatment coverage across U.S. urology residency programs. Methods A total of 148 accredited U.S. urology residency programs were identified and evaluated from the American Urologic Association that participated in last year’s match. Each program's public-facing urology department website, affiliated graduate medical education (GME) website (with linked benefits booklet if applicable), and program details were reviewed. Programs were assessed for the availability of information regarding infertility treatment benefits, gender-specific coverage (male, female, or unspecified), institutional details describing benefit access, and available data such as lifetime coverage limits and cycle caps. Data were descriptively analyzed. Results Out of 148 programs, 40 (27%) provided available information regarding infertility treatment benefits while 140 programs (95%) provided information on general medical benefits. Among these 40 programs, 22 (55%) specified coverage for female fertility services, 16 (40%) included male-specific benefits, and 18 (45%) referenced fertility coverage without specifying sex. Six programs (15%) included information on female-only benefits, whereas none exclusively listed male-specific benefits. (Table 1) Male fertility services were variably represented among the 40 programs with fertility benefit information. There were 6 programs (15%) specified sperm cryopreservation, 4 programs (10%) that included sperm extraction, and 1 program (2.5%) mentioned covering vasectomy reversal. Among programs that disclosed cost-related information, the average lifetime medical fertility benefit was $17,500 (n=8), with an additional $7,800 for pharmacy benefits (n=10). The average of total lifetime fertility coverage maximum was $28,375 (n=20). Only 4 programs (10%) specified a cycle limit, averaging 2.75 cycles. Regional variation in the availability of fertility benefit information was observed, with the Western, North Central, and South Central regions demonstrating the highest proportions of programs providing infertility treatment benefit information (56%, 31%, and 29%, respectively), and the New York region the lowest (5.9%). However, these differences did not reach statistical significance (p = 0.092). Conclusions Fewer than one-third of U.S. urology residency programs provide accessible information regarding infertility treatment coverage. Male-specific services, despite the specialty’s clinical focus and the growing recognition of infertility as a systemic health concern, remain underrepresented. The limited transparency of fertility benefits, almost always requiring indirect access through GME resources, may hinder informed reproductive planning. As many male trainees delay childbearing alongside their partners, timely and visible support for infertility coverage is essential. Improving the availability and clarity of these benefits may help address both reproductive and broader health needs for future urologists. Disclosure No