Pd37-11 Impact of in-Vitro Fertilization State-Level Mandates on Access to in-Vitro Fertilization Care and Clinical Outcomes

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation II (PD37)1 May 2024PD37-11 IMPACT OF IN-VITRO FERTILIZATION STATE-LEVEL MANDATES ON ACCESS TO IN-VITRO FERTILIZATION CARE AND CLINICAL OUTCOMES Amelia A. Khoei, Phyllis Yan, Rodney L. Dunn, David Suh, Marissa S. Weiss, Kristian Black, Erica E. Marsh, Edward C. Norton, Vanessa K. Dalton, and James M. Dupree Amelia A. KhoeiAmelia A. Khoei , Phyllis YanPhyllis Yan , Rodney L. DunnRodney L. Dunn , David SuhDavid Suh , Marissa S. WeissMarissa S. Weiss , Kristian BlackKristian Black , Erica E. MarshErica E. Marsh , Edward C. NortonEdward C. Norton , Vanessa K. DaltonVanessa K. Dalton , and James M. DupreeJames M. Dupree View All Author Informationhttps://doi.org/10.1097/01.JU.0001009464.98066.03.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In-vitro fertilization (IVF) is an important treatment for couples affected by male-factor infertility, although access to IVF care varies across the United States (US). By 2020, 11 states had passed laws mandating insurance coverage for IVF, but only six of those states also mandated insurance coverage for male infertility procedures. It remains unknown how male infertility coverage mandates impact IVF outcomes. Therefore, our objective was to compare IVF outcomes (pregnancy, live birth, multiple birth, and preterm birth rates) in 3 groups of states. METHODS: We obtained nationwide claims data from over 80 million insured US individuals from 2003 to 2021 from Optum's de-identified Clinformatics® Data Mart Database. We identified IVF cycles using Current Procedural Terminology (CPT) codes for oocyte retrievals and embryo transfers and excluded oocyte retrievals performed for fertility preservation. Pregnancies, live births, multiple births, and preterm (<37 weeks) births were identified using CPT, International Classification of Diseases, and Diagnosis Related Group codes.States were categorized into three groups: 1) states mandating IVF coverage and male infertility care (CT, MA, NJ, NY, DE 2018-20, UT 2018-20); 2) states mandating IVF coverage but not male infertility care (AR, HI, IL, MD, RI); and 3) all remaining states, including both DE and UT from 2003-2017. Within each group of states, we calculated pregnancy, live, multiple, and preterm birth rates and 95% confidence internals (CIs) following IVF using the cumulative incidence method to address competing outcomes. RESULTS: IVF use was almost six-fold higher in Group 1 states than Group 3 states. Pregnancy, live birth, multiple birth, and preterm birth rates after IVF were similar across groups (Table 1). CONCLUSIONS: IVF utilization is highest in states with an IVF coverage mandate that includes male infertility coverage. However, birth outcomes were similar across states regardless of mandate. While IVF mandates may not be associated with differences in clinical outcomes, they do positively assist couples by improving access to specialty fertility care. Policymakers should consider IVF coverage mandates that include male infertility care as tools for expanding access to infertility treatments. Source of Funding: Eunice Kennedy Shriver National Institute of Child Health & Human Development - 1R01HD103603 © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e804 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Amelia A. Khoei More articles by this author Phyllis Yan More articles by this author Rodney L. Dunn More articles by this author David Suh More articles by this author Marissa S. Weiss More articles by this author Kristian Black More articles by this author Erica E. Marsh More articles by this author Edward C. Norton More articles by this author Vanessa K. Dalton More articles by this author James M. Dupree More articles by this author Expand All Advertisement PDF downloadLoading ...