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Money Matters When Choosing an Infertility Treatment

If advice is cheap, ART — assisted reproductive technology — is not, and the difference in cost has a significant effect on the treatments pursued by infertile couples in the United States.//

Not surprisingly, an infertile couple’s income makes a difference in whether they pursue an expensive technology such as in vitro fertilization, but income and insurance coverage also have a strong impact on whether they choose less costly options such as medication and surgery, according to a new study in the journal Health Services Research.

Income and insurance did not affect whether couples sought out a doctor’s advice, the lowest-cost and least effective type of treatment, say J. Farley Ordovensky Staniec, Ph.D., of the University of the Pacific in Stockton, Calif., and Natalie Webb, Ph.D., of the Naval Postgraduate School in Monterey.

“For the 11 percent of women of childbearing age facing fertility problems and considering their options, money does matter,” Staniec said.

The researchers looked at 1995 survey data from nearly 11,000 women, 1,210 of whom had fertility problems or were part of a couple with fertility problems. Of the 1,091 women ages 22 and older with problems, nearly six percent sought advice only from their doctors, 7 percent had fertility tests but no other treatment, 11 percent used drugs to induce ovulation but no other treatments, 3 percent had surgery and nearly 6 percent pursued treatments such as in vitro fertilization and related procedures.

By comparing these treatment options with information about the women’s income and insurance, Staniec and Webb found that low-income women were only 65 percent as likely as their richer counterparts to seek help for infertility.

However, treatment costs influenced treatment choices for most women in the study, the researchers concluded. “For options beyond ‘advice only,’ income plays a significant role in all but the choice to use ovulatio
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