Abstract

Patients with underlying medical conditions are at a higher risk of peripartum complications that may compromise both their health and that of the eventual child. Reproductive autonomy is the primary consideration supporting an individual’s right to access fertility treatment. However, health care providers have a duty to support the well-being of their patients and in certain cases may limit patient autonomy to prevent harm. Comorbidities may affect the health of a future child and may restrict the future parent’s ability to care for the child. These concerns must in turn be balanced to avoid prioritizing ableist notions of proper parenting to determine access to fertility treatment. Reproductive endocrinologists should consult maternal fetal medicine physicians and specialists in the patient’s condition to ensure that decisions regarding the provision of fertility treatment are grounded in evidence rather than stereotypes about patients with disabilities. Pregnancy remains a reasonable option for many patients with comorbidities with appropriate monitoring by subspecialists and significant counseling about risks and alternatives to pregnancy.