The territorial heterogeneity of the severity of the problem of female infertility is a serious challenge for public health, reflecting the injustice in the availability of medical care for the Russian population. The pandemic has affected the reproductive health of men, and the issue of the impact of COVID-19 on women's reproductive health has not been fully clarified. The purpose of the article is to determine how the pandemic affected the territorial heterogeneity of the incidence of infertility in women and its change. Materials and methods. Used: data on female infertility for 2011-2023 for the subjects of the Russian Federation, data on assisted reproductive technologies (ART) for 2018-2021, an integral rating of the subjects of the Russian Federation on the socio-economic situation in 2022. The dynamics and variability of the indicator in the pre-pandemic period and in the period 2019-2023 were analyzed. Correlation analysis was used. Results. In all federal districts and in the country as a whole, the incidence of infertility decreased sharply after 2019, except for the Far Eastern District. In Moscow, the decrease in morbidity occurred earlier, in St. Petersburg, an increase in morbidity was observed against the background of the pandemic. In the 10 regions with the highest and 10 regions with the lowest incidence rates in 2011 to 2019, the indicators converged, and during the pandemic, on the contrary, they began to diverge. On the contrary, there was an increase in differences in the indicator between the regions with the highest and lowest incidence in 2023 from 2020. The variability of the incidence rate has increased dramatically in the country since 2019, and its highest rates in 2023 were observed in the North Caucasus and Far Eastern Federal Districts, which include subjects with the worst socio-economic situation. The correlation coefficients of the increase in morbidity from 2011 to 2023 with the integral rating of regions and with the incidence rate in 2023 are 0.24 and 0.62, respectively, and the incidence rate in 2023 with its increase from 2019 is 0.40. In 41 subjects of the Russian Federation in 2022, there were no women who underwent artificial insemination, and in 39 subjects there were no women who underwent IVF, 24.9% and 22.8% of all infertility cases in the country were noted in them. The coefficient of variation for the coverage rate of artificial insemination in 2022 was 207.8%, for the IVF coverage rate of 135.1%. Discussion. The different regional dynamics of the incidence of female infertility suggests that a decrease in the availability of medical care during the pandemic is not the leading factor in such a pronounced decrease in the frequency of female infertility in the country. A more pronounced decrease in the incidence rate in poor regions than in neighboring regions with a better economic situation indicates that the economic factor is important in increasing the territorial heterogeneity of female infertility. Although the proportion of births after ART is not high, their number is five times higher than the number of children who died before the age of one year, which reflects the presence of unused reserves for the growth of the number of births in the country due to the limited availability of ART in all regions of the country. Conclusion. Infection with the SARS-CoV-2 virus did not lead to an increase in the incidence of female infertility, on the contrary, the incidence rate decreased during the pandemic. The reasons for this decline are not only a decrease in the availability of specialized medical care, but also economic reasons that affect women's intentions to have children. The pandemic has significantly increased the territorial heterogeneity of the incidence of infertility among women in the Russian Federation after its noticeable decrease in the previous period, which is associated with the under-occurrence of cases of female infertility. It seems more relevant to solve the problem of reducing heterogeneity in women's access to ART procedures.