Infertility Insurance Mandates Lower Multiple Births in IVF*

(San Francisco, CA)—In a study from Massachusetts, researchers have found that mandated infertility insurance coverage effectively lowers the multiple birth rate in in vitro fertilization (IVF).

The study was presented by David Frankfurter, M.D., of Women and Infants Hospital of Rhode Island, at the International Federation of Fertility Societies (IFFS) 16^th World Congress on Fertility and Sterility/American Society for Reproductive Medicine (ASRM) 54^th Annual Meeting in San Francisco, California.

The latest figures from the National Center for Health Statistics show a significant increase in the number of multiple births in the United States that many people feel is a direct result of overutilization of infertility services. There are currently 14 states that have some form of mandated infertility insurance coverage. The researchers set out to compare mandated states to non-mandated states to discover if having access to infertility treatment because of insurance coverage contributes to higher rates of multiple births.

This retrospective study analyzed data from the 1995 Assisted Reproductive Technology (ART) Fertility Clinic Success Rate Report. Programs were divided into two groups; those in states with comprehensive mandated infertility coverage and those in states without such mandates. The number of embryos transferred and the multiple birth rate were used as comparisons.

Of the 261 programs included in the report, 242 were in non-mandated states. They performed a total of 31,009 embryo transfer cycles (ET) in women younger than 35, those 35 to 40 years of age, and those over age 40. There were 19 programs in states with mandated coverage. They performed a total of 6,421 ET cycles in the women in all three age groups.

The study showed that programs in states with mandated insurance coverage transferred fewer embryos during ART procedures than did programs in non-mandated states. Programs in

mandated states also had significantly lower multiple birth rates per ET than did programs in non-mandated states.

The authors concluded that infertility insurance mandates do lower the multiple birth rate in IVF. They theorize that the reasons for the lowered multiple birth rate could be due to decreased pressure from patients to achieve pregnancy at any cost by transferring more embryos and due to pressure from the insurance companies to reduce the multiple birth rate.

According to J. Benjamin Younger, M.D., Executive Director of the ASRM, "We have long been advocating for adequate insurance coverage for all those suffering from the disease of infertility. This study is important because it shows it is an effective means of lowering the troubling multiple birth rate associated with ART. The time has come for a federal infertility insurance mandate to ensure that those suffering from infertility are given the same insurance coverage as those suffering from any other disease."

The American Society for Reproductive Medicine (ASRM), based in Birmingham, Alabama has more than 9,000 members who are devoted to advancing knowledge and expertise in reproductive medicine and biology, including obstetricians-gynecologists, urologists, endocrinologists, research scientists, medical technologists, and allied health professionals.

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