Mp42-07 Higher Pregnancy and Live Birth Rates After Varicocelectomy in States With in Vitro Fertilization Mandates That Include Male Infertility Coverage

You have accessJournal of UrologyInfertility: Therapy (MP42)1 May 2024MP42-07 HIGHER PREGNANCY AND LIVE BIRTH RATES AFTER VARICOCELECTOMY IN STATES WITH IN VITRO FERTILIZATION MANDATES THAT INCLUDE MALE INFERTILITY COVERAGE Kristian M. Black, Phyllis Yan, Rodney L. Dunn, David Suh, Marissa S. Weiss, Amelia A. Khoei, Erica E. Marsh, Edward C. Norton, Vanessa K. Dalton, and James M. Dupree Kristian M. BlackKristian M. Black , Phyllis YanPhyllis Yan , Rodney L. DunnRodney L. Dunn , David SuhDavid Suh , Marissa S. WeissMarissa S. Weiss , Amelia A. KhoeiAmelia A. Khoei , 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.0001008688.39367.31.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Varicocelectomy is an important treatment for male infertility that can decrease the need for in vitro fertilization (IVF). Yet, only 6 of the 11 states with IVF insurance mandates also include coverage for male infertility care. It is unclear how unequal reproductive health insurance coverage impacts reproductive outcomes following varicocelectomy. Our objective was to determine how varicocelectomy rates and associated fertility outcomes are impacted by male infertility coverage mandates. METHODS: Comprehensive claims data from over 80 million insured individuals in the US were obtained from Optum's de-identified Clinformatics® Data Mart Database. We identified men aged 26 and older who underwent varicocelectomy from 2003 to 2020, their female partners, and associated pregnancy and live birth rates, including the use of IVF using insurance billing 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 DE and UT from 2003-2017. The rate of varicocelectomy per 100,000 men and the cumulative incidence of pregnancy and live births after varicocelectomy, including those occurring without an IVF cycle, were calculated for each state group with a 95% confidence interval (CI). RESULTS: Data from 5,280 males and their female partners were analyzed. Varicocelectomy rates were highest in Group 1 states. Group 1 states also had the highest pregnancy and live birth rates. The pregnancy rate without IVF in Group 1 states was 3 and 4 times higher than in Group 2 and Group 3 states, respectively. The live birth rate without IVF was five times higher in Group 1 states compared to Group 2 and Group 3 states. CONCLUSIONS: States with IVF mandates that include male coverage had the highest varicocelectomy rate. The pregnancy and live birth rates following varicocelectomy were also highest in these states with a larger percentage occurring without the use of IVF. Policymakers can improve reproductive outcomes by introducing or expanding IVF mandates to include coverage for male infertility care, including varicocelectomy. 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: e686 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kristian M. Black 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 Amelia A. Khoei 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 ...