GYNs at the REI gates: unsolvable conundrum or unambiguous opportunity?

Contemporary fertility care has matured from a restricted, special interest in women's health care where success sometimes made magazine covers to a well-honed start-to-finish process with ever-improving success rates and an ever-expanding panoply of treatment options. Innovations in both lab and clinic have been exponential and game changing. The specialty now finds itself in the enviable position of an extensive menu of highly successful treatment options but a complicated set of circumstances of access to these options. Emerging technology such as artificial intelligence could facilitate this transition and improve access. But a key corollary to access and leveraging new technology relates to having a credentialed team to deliver care on scale and maintain best practices and outcomes. The current debate focuses on this Rubik's cube of personnel needs in reproductive endocrinology (REI) and weighs how best to expand access and maintain the culture and spirit of REI. A model to include providers other than REI viz, GYNs or APPs is now front and center. The objective of this Opinion is to define the current context for fertility care and within that context evaluate options and consider what a collaborative model that incorporates a spectrum of non-REI providers including GYNs might look like. Such a model may be feasible (or not) to expand access to care on scale while maintaining high standards and best outcomes.