Fertility Treatments as Part of a Fractured Insurance System

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Fertility Treatments as Part of a Fractured Insurance System

Infertility is a wide-spread health concern affecting 6.1 million American couples. Despite so many Americans being affected, most health insurance benefits will not cover treatments, including in vitro fertilization (IVF). Couples are left to pay for expensive IVF procedures on their own, with costs ranging from $12,000 to $15,000 per cycle.

“Today, about 1 in 60 newborns was conceived by in vitro fertilization. But even as demand for IVF rises, insurance coverage remains limited,” reports Sophie Bearman of CNBC. “A 2017 study by Mercer, a health-care consulting group, found that only 26 percent of companies with over 500 employees cover the procedure. The result is that many Americans are left paying fully out of pocket.”  To increase their chances of success, couples are  turning down a safer procedure, elective single embryo transfer (eSET), and instead transferring multiple embryos.

While the consolidation of embryos can save money, there are increased risks overall. Multiple embryo transfers may lead to multiple births, which can be riskier for the woman’s health and the babies she is carrying.

At the U.S. Center for Disease Control, Dmitry Kissin, MD told CNBC that the health concerns for mothers carrying multiples include medical issues such as gestational diabetes, high blood pressure, hypertension, and preeclampsia. Newborns run the risk of being delivered prematurely, have a low birth weight, may have developmental disabilities, and other health issues.

The cost of treating these illnesses from multiples is more expensive than the IFV cycle price tag. According to reports from 2013, the price of a single pregnancy sits at around $21,000. For twins, the cost increases to $105,000, and for triplets, it skyrockets to $400,000.

President of the American Society for Reproductive Medicine Dr. Richard Paulson said, “It turns out that paying for infertility care and controlling the number of embryos that are transferred would actually save money for the overall cost of medical care in the United States.”

With better insurance coverage for the millions of Americans dealing with infertility, women and men may not have to make the tough choice of whether to transfer more than one embryo. In addition to lessening health concerns, cost of medical care related to multiple pregnancies would decline as well. It’s time to rethink health coverage for IVF – it’s way overdue.