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Preterm births, multiples, and fertility treatment
Date:4/16/2014

ople/pasquale_patrizio-2.profile for pasquale">Pasquale Patrizio, professor of obstetrics and gynecology at Yale and director of the Yale Fertility Clinic.

Few Americans have sufficient insurance coverage for fertility treatments. "This lack of coverage creates a moral hazard, where patients' immediate financial interests are best met by maximizing their pregnancy chances on each treatment cycle, despite the health risks and long-term costs associated with multiple gestations and births," the authors write.

Specifically, financial incentives lead patients to persist with controlled ovarian stimulation (COS), which is less expensive than IVF per treatment cycle and more often covered by insurance, but is also more difficult to control than IVF and results in more multiple births per year than IVF. The fee for a full IVF cycle is more than $10,000, and it is more than $3,000 for each embryo transfer.

The Affordable Care Act "did little for fertility patients," the article states, since its "essential benefit" provision does not mandate coverage of fertility treatment. While a few states do require IVF coverage, the article says that "the total value of the benefit may be capped at as low as $15,000 or the minimum number of cycles that must be covered may be as low as one." In addition, many of the mandates limit access to IVF to patients who have failed to achieve pregnancy with COS, leading some insurers to require as many as six cycles of it.

Patients who do undergo IVF "have a financial incentive to transfer more than one embryo so as to limit the number cycles and transfers they undergo," according to the article. Transferring more than one embryo at a time increases the chance of multiples.

The authors also expressed concern that patients are not making fully informed decisions about which fertility procedures they choose. Studies of IVF patients shows that while many patients accept treatment options associated with high rates of twins
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Contact: Susan Gilbert
gilberts@thehastingscenter.org
845-424-4040 x244
The Hastings Center
Source:Eurekalert

Page: 1 2 3

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