Women Whose Health Insurance Covers IVF Are More Likely To Have A Baby

Yet only 15 states mandate that insurers cover infertility treatment -- and just 5 states require IVF coverage.
03/28/2017 05:27pm ET
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The lead author of a study on IVF and insurance said: “The difference is that women with coverage were more likely to come back and try again if they were initially unsuccessful.”

Women who pursue in vitro fertilization (IVF) to become pregnant have a greater chance of giving birth if they have health insurance that covers the expensive procedure, according to new research at Washington University School of Medicine in St. Louis.

While the study’s lead author, Emily S. Jungheim, allowed in a statement that the finding was “simple and possibly obvious,” it documents the link between insurance coverage and better outcomes.

The high cost of a single IVF procedure ― estimated by the American Pregnancy Association to be $12,000 to $17,000 ― stops many women from seeking a second treatment if the first one fails.

“The difference is that women with coverage were more likely to come back and try again if they were initially unsuccessful,” Jungheim said. “Given that they had the ability to try more times, they had a higher chance of giving birth.”

Just 15 states mandate that insurance companies must cover infertility treatment; the other 35 do not. And of the 15, just five specifically mandate IVF: Illinois, Massachusetts, Rhode Island, Connecticut and New Jersey.

Many companies offer insurance with fertility coverage without being required to. The Affordable Care Act does not require coverage for infertility treatments. About 10 percent of U.S. women of child-bearing age have consulted a doctor for infertility issues.

The success of just one IVF procedure ranges from more than 40 percent for women younger than 35 to about 15 percent for women older than 40, says the American Pregnancy Association. This suggests that older mothers may be even more reliant on insurance and the need for coverage of extra treatment rounds.

Jungheim’s study of the likelihood a woman’s use of IVF would result in a live birth involved a single clinic, the Fertility and Reproductive Medicine Center at Washington University. The center is near the Illinois state line, which presented a natural study condition: Illinois mandates IVF coverage and Missouri does not.

From 2001 to 2010, the clinic tracked 1,572 women who sought IVF treatment.

Fifty-six percent of the women had insurance coverage for IVF while 44 percent paid for the procedure out of pocket. The researchers found that 70 percent of the women with insurance returned for a second IVF treatment if the initial treatment was unsuccessful.

Ultimately, for women with IVF coverage, the average likelihood of giving birth after up to four attempts was 59 percent, or 515 births. This compared with 51 percent, or 350 births, for women without coverage ― a difference that is statistically significant, noted a press release.

Jungheim said that the study findings “highlight the critical role insurance plays in determining whether a woman with fertility issues ultimately will have a baby.”

She added that this research indicates a need for legislation that mandates IVF insurance coverage.

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