Access to and use of infertility services in the United States: framing the challenges

Fertility and Sterility
Eli Y Adashi, Laura A Dean

Abstract

An overview of access to and use of general infertility and assisted reproductive technology (ART) services in the United States (U.S.) shows a declining trend for the ever-use of infertility services. Moreover, the use of ART services lags relative to other member nations of the Organization for Economic Co-operation and Development (OECD). Access to and use of general infertility and ART services is primarily undermined by a severely constrained underwriting universe dominated by self-insured employers and by a finite number of state infertility insurance mandates. The contribution of traditional public and private payers to the underwriting of ART is limited. As compared with OECD member nations wherein the access to and underwriting of general infertility and ART services is universal, the current status quo in the U.S. can only be characterized as dismal. Further, the current state of affairs is socially unjust in that the right to build a family in the face of infertility appears to have become a function of economic prowess. Given the dominance of the self-insured employers as underwriters of general infertility and ART services, advocacy directed at this interest group is likely to prove most productive. Improving the s...Continue Reading

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Citations

Jul 13, 2018·Maternal and Child Health Journal·Amanda E JanitzLaTasha B Craig
Jan 4, 2020·Maternal and Child Health Journal·Embry M HowellCaitlin Cross-Barnet
Sep 11, 2020·Health Equity·Margot Kelly-Hedrick, Marielle S Gross
Aug 2, 2017·Paediatric and Perinatal Epidemiology·Aniket D KulkarniDmitry M Kissin
Nov 28, 2020·Journal of Assisted Reproduction and Genetics·Iris G InsognaMark D Hornstein
Dec 18, 2019·Fertility and Sterility·Katherine Tierney, Yong Cai

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