The journal Reproductive Biology and Endocrinology recently published a review of the literature and a critical evaluation of the state-mandated third-party insurance coverage for in vitro fertilisation (IVF) in the United States.
First author Benjamin Peipert, MD, chief resident in ob/gyn at Duke University, noted that the American Society for Reproductive Medicine (ASRM) estimates that less than a quarter of infertile couples have adequate access to infertility care. "Infertility is one of the most common medical conditions in America," he added.
The U.S. uses assisted reproductive technology (ART) less frequently per person than other developed nations that fund IVF through national health programs.
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| State-mandated IVF insurance coverage's effect |
According to Peipert, "Insurers in America have traditionally thought of infertility as a socially constructed affliction, and IVF as an elective intervention, despite the fact that numerous studies have shown that the per capital incremental cost of fertility coverage is very low and significantly less than many commonly covered treatments."
One of the biggest impediments to care, in Peipert's opinion, is the cost of infertility treatment, particularly IVF. Thankfully, he added, "state infertility insurance regulations have become an essential tactic for enhancing access to infertility care.
While Maryland established the first IVF mandate in the nation in 1985, West Virginia became the first state to pass an insurance mandate for third-party coverage of infertility services in 1977.
Twenty states have implemented laws requiring insurers to pay for or provide coverage for the identification and management of infertility to date.
Additionally, ten of those states presently have "comprehensive" IVF mandates, which call for third-party coverage of IVF with the fewest possible constraints on patient eligibility, exemptions, and lifetime limits.
Peipert noted that mandates are associated with higher rates of single embryo transfer and, consequently, lower rates of multiple births. The presence of IVF mandates and high live birth rates have been linked in recent studies, but more research is required to fully understand this potential association.
State mandates on infertility aid in reducing differences in IVF use and outcomes related to racial/ethnicity, education, geography, and income; however, Peipert claimed that these mandates "do not ameliorate these disparities, demonstrating the multifactorial nature of disparities in access to healthcare in our nation." "Mandates are necessary but insufficient to reduce infertility care disparities,"
The quality of infertility care may be improved by these regulations, Peipert said, despite the fact that doctors and advocacy organisations work to increase insurance coverage for IVF and other infertility treatments.
Peipert advises that in order to support legislative change aimed at enhancing access to infertility care, patients, medical professionals, and the general public work together with RESOLVE: The National Infertility Association and other advocacy groups. Additionally, he advised people to write to their state and federal representatives in support of legislation that would make it easier for people to access family-building choices like IVF.
In order to further increase access to infertility care, the authors of this study believe that their study will provide guidance for future research projects and new legislation.
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