Public Funding Widens Access to Fertility Treatment
After Quebec mandated IVF coverage, study found change in patient demographics
"One of the goals of the funding was to reduce preterm births, and they have already done that," Zelkowitz said.
The study findings are in conflict with earlier U.S. studies, which have shown that even when patients have access to public funding for assisted reproductive technology, barriers continue to exist, including social, economic and ethnic obstacles. As a result, these earlier studies suggested, the typical patients remain older, wealthier, more-educated white couples.
In the United States, infertility affects about one of eight women of reproductive age and their partners, according to the American Society for Reproductive Medicine.
Currently, 15 states have passed laws that mandate insurers to cover or offer coverage for infertility diagnosis and treatment, but some states exclude coverage for IVF.
Assisted reproductive technology is typically defined as fertility treatments in which both eggs and sperm are handled, such as IVF, but not procedures such as taking medicine to stimulate egg production, according to the U.S. Centers for Disease Control and Prevention.
Only about 5 percent of infertile couples need assisted reproductive technology, the society estimates.
For others, egg stimulation or lifestyle changes such as losing weight or stopping smoking can help them achieve a pregnancy.
However, for those who do need IVF, the cost can be prohibitive. A cycle of IVF costs about $12,400, the society estimates.
The study findings about patient demographics changing after public funding became available do not surprise Dr. Wendy Schillings, a fertility specialist in Allentown, Pa. When she meets patients who have only diagnosis covered, she said, they often delay treatment if they need IVF, hoping to save up the money needed.
Couples who don't have IVF coverage often ask for more embryos to be transferred, she said, and she then counsels them on the risks of multiple births.
"Absolutely lower-income couples can do it [seek treatment] and will do it," Schillings said. However, for those with higher incomes, the decision may involve fewer sacrifices, she added.