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.
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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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Before You Go

Celebs Share Their Experience With IVF
Khloe Kardashian(01 of12)
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Khloe Kardashian has been frank about her struggle with infertility, her rocky marriage and her attempt at IVF. Back in 2013, when she was 28 years old and still married to former NBA player Lamar Odom, she revealed in an episode of "Kourtney & Kim Take Miami" that her body does not ovulate (release an egg), and her uterine lining isn’t thick enough to support a pregnancy.

But a lot can happen in three years, and now that she and Odom are separated, Kardashian is glad that the fertility treatments did not work, she said in a March 2016 episode of "Kocktails with Khloe."

At the time, I was like ugh! Gotta have a baby. That’s all I wanted at that time. And I thought maybe it would like, fix the situation. So I’m also happy that it didn’t happen. I was young, I was 27, and I thought, Oh my god, a baby will fix this!" Kardashian went on to say that she hopes that she has children one day.
(credit:Cindy Ord via Getty Images)
Chrissy Teigen(02 of12)
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Chrissy Teigen and her husband John Legend welcomed their daughter in April 2016, but before she was born, the couple struggled with infertility and had to use IVF to get pregnant. Once they did conceive, Teigen continued to be open about the process, and she got some flack when she revealed the couple had chosen the baby’s sex before implantation.

Teigen took the criticism in stride, saying on Twitter that misunderstanding about the IVF process in general may have led some to believe that the couple had done IVF specifically to make a female embryo, or that “choosing” a female embryo meant discarding all the male embryos. In fact, that’s far from the case, and Teigen said that she and her husband have several embryos of both sexes in storage for future children. The controversy didn’t stop her from making a joke about it, though.

"I also picked the embryo with a taste for bacon, a knack for magic and size 7 feet so she can always find shoes."
(credit:Jason LaVeris via Getty Images)
Hugh Jackman(03 of12)
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Hugh Jackman and his wife Deborra-Lee Furness always knew that they were going to adopt one day -- but they assumed they’d have biological children first. The couple tried IVF twice, though each cycle ended in miscarriage. He recalled the heartbreak in a 2013 interview with Good Housekeeping magazine and said each loss was a “massive letdown.”

"While you're going through IVF and get pregnant, every day [the feeling is], We're still holding! We're still holding…!” Jackman said. "You know how precarious it is and how much she's been through to get there. And [miscarriage] is a massive letdown. It's really difficult -- and much harder for the woman."

The couple then began exploring adoption in the U.S., because Australia, where they’re from, didn’t allow couples to pursue both adoption and IVF at the same time. Eventually the couple ended up adopting two children: a newborn boy in 2000 and a newborn girl in 2005.
(credit:Jeff Vespa via Getty Images)
Nia Vardalos(04 of12)
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Nia Vardalos and her husband Ian Gomez struggled with infertility for nine years before becoming parents. In March, Vardalos told People magazine that she and her husband experienced 13 failed IVF treatments, several miscarriages and had no success going the surrogacy route.

"It was a sad process for me to become a mom, and a long process,” Vardalos said to People. "I felt so embarrassed that I couldn't have a biological child.”

But she eventually did become a mom. In 2008, the California foster care system matched the couple with a three-year-old girl who would eventually become their daughter. Vardalos wrote about her experience in the book Instant Mom, which came out in 2013, and she is now an outspoken advocate for adoption.
(credit:John Lamparski via Getty Images)
Elizabeth Banks(05 of12)
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Elizabeth Banks and her husband Max Handelman have two sons who were born with the help of a gestational surrogate in 2011 and 2012. Banks says they needed help because embryos wouldn’t implant in her womb. After her first son was born, she told Women’s Health magazine that stories about other couples' experiences helped them make the decision to go with surrogacy.

"It helped that other moms had said that once they had their babies, they forgot they were ever pregnant,” she told them in a 2012 interview. "So once my focus became the baby and not the pregnancy, it was a very easy decision.”
(credit:Fred Prouser / Reuters)
Giuliana Rancic(06 of12)
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E! News host Giuliana Rancic endured three IVF cycles and one miscarriage before finding out that she had breast cancer. Because she could no longer attempt to carry her frozen embryos due to the cancer treatment, she and husband Bill Rancic asked a gestational surrogate to carry their son, who was born in 2012. In a 2012 interview with CNN, Rancic got candid about the heartbreaking experience.

"My first IVF I did get pregnant -- that was the miscarriage," Rancic said. "But the second one, I did not get pregnant, and that was the biggest kick in the stomach, because I just could not believe you go through so much to get those eggs and put them in, and when the doctor calls you, to hear, 'Oh, sorry, it didn't work.' That was the most shocking. I would go, 'I'm a good person, and I could give someone the greatest life of all, but yet I can't get pregnant.'"
(credit:John Shearer via Getty Images)
Courtney Cox(07 of12)
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Cox had several miscarriages before doctors found out that a rare antibody in her blood prevented pregnancies from reaching full term. She tried IVF twice before successfully conceiving her daughter, and was frank about how difficult it was to continue filming a comedic TV show while suffering repeated pregnancy losses.

"I remember one time I just had a miscarriage and Rachel was giving birth,” Cox said in a 2004 interview with Dateline NBC, the year “Friends” ended. "It was like that same time. Oh my God, it was terrible having to be funny."
(credit:Frazer Harrison via Getty Images)
Nicole Kidman(08 of12)
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Nicole Kidman has two adopted children with ex-husband Tom Cruise and two children with current husband Keith Urban. She gave birth to her first daughter with Urban in 2008, and a gestational carrier gave birth to their second one in 2011.

"I had tried and failed and failed and failed,” Kidman said in a 2008 interview with Australia’s Who magazine. "Not to be too detailed, but I’ve had an ectopic pregnancy, miscarriages and I’ve had fertility treatments. I’ve done all the stuff you can possibly do to try get pregnant. Every woman who has been through all those ups and downs knows the depression that comes with it. So the way it just happened with Sunday was like, ‘What?’ The percentages were so low. It is the miracle in my life.”
(credit:John Shearer via Getty Images)
Sarah Jessica Parker(09 of12)
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Sarah Jessica Parker and her husband Matthew Broderick have three children. While Parker gave birth to their oldest in 2002, their twin daughters were born via gestational surrogate in 2009. She told Vogue magazine after they were born that meeting them for the first time in the hospital room was unlike anything else she had ever experienced.

"Meeting your children rather than giving birth to them, it’s as if, um, it’s -- suspended animation,” she said to Vogue. "The gestational experience is gone. It’s as if everything else disappears for a moment, and the world goes silent and -- I can’t explain it except to say that nothing else existed.”
(credit:Desiree Navarro via Getty Images)
Brooke Shields(10 of12)
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Brooke Shields wrote about her struggle to get pregnant and her postpartum depression in her 2005 book Down Came The Rain. She was 36 when she first started IVF and endured a miscarriage and several failed IVF cycles before they decided to try it one last time in 2002. It worked, and she gave birth to a daughter in 2003. She was definitely not a fan of the IVF injection process, she writes in her book.

"The whole process was quite an ordeal, and we became slaves to the time of day and to little vials of liquid," Shields wrote. "We'd find ourselves out at dinner with friends, and then we'd have to sneak off to a coat room, where we'd huddle over syringes and a travel-size cooler filled with small bottles of drugs."

She ended up conceiving again, this time without assistance, and gave birth to her second daughter in 2006.
(credit:Mireya Acierto via Getty Images)
Emma Thompson(11 of12)
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Emma Thompson and her husband Greg Wise welcomed their first child, a daughter, in 1999. She was conceived with help from IVF treatment, but when it came time for a sibling, fertility treatments just didn’t work the second time around. The failure caused Thompson to experience deep depression, and she said there were days she couldn’t get dressed or leave the house.

"IVF is very upsetting. It's a brutal process and it's very emotional. It's really hard,” said Wise in a 2014 interview with The Daily Mail. "But then you pick yourself up, look around and see this unbelievably beautiful little baby you've got anyway."

The couple eventually went on to adopt 16-year-old son Tindyebwa Agaba, a former Rwandan child soldier who had moved to Britain.
(credit:Carlo Allegri / Reuters)
(12 of12)
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Celine Dion and her late husband René Angélil underwent IVF seven times in order to give birth to their three children, a son born in 2001 and then twin boys born in 2010. Their eldest child was conceived in a single IVF cycle and born when she was 33, but getting pregnant a second time at age 42 was much more difficult. She endured a miscarriage and back-to-back fertility treatments until she became pregnant with triplets. Part way through the pregnancy, though, one of the fetuses died, leaving her with twin boys.

She told the Daily Mail back in 2013 that every time an IVF attempt failed, it was a disappointment not only to herself and her husband, but their oldest child.

"‘I needed to protect myself a little by thinking that I already had one child,” she told the Daily Mail. "I couldn’t make all my life, my spirituality, my strength, my happiness, dependent on the next pregnancy. I would say to René-Charles, “I hope you are going to have a brother or sister,” and each time when it didn’t work I’d tell him, “It didn’t work, we’ll try again.”
(credit:Mario Anzuoni / Reuters)

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