Expensive but worth it: older parents’ attitudes and opinions about the costs and insurance coverage for in vitro fertilization

Abstract

Objective To describe older parents’ attitudes and opinions about the costs and insurance coverage for IVF. Design Qualitative interview study. Setting Two Northern California IVF practices. Patient(s) Sixty women and 35 male partners in which the woman had delivered her first child after the age of 40 years using IVF. Intervention(s) Two in-depth interviews over 3 months. Main Outcome Measure(s) Thematic analysis of interview transcripts. Result(s) We found that although the costs of IVF were perceived as high, even by those with insurance or who could afford them, the cost of IVF relative to other expenses in life was dwarfed by the value attributed to having a child. Women were twice as likely as men to support insurance coverage for IVF. Both men and women with complete or partial IVF insurance coverage were more likely to support insurance than those without coverage. There was a broad range of attitudes and opinions about the appropriateness of IVF insurance coverage, which addressed questions of age, gender equality, reproductive choice, whether infertility is a medical illness, and the role of personal and societal economic equity and responsibility. Conclusion(s) Despite a generally favorable opinion about the appropriateness of insurance coverage by those who have successfully undergone IVF treatment, the affordability of IVF remains an unresolved dilemma in the United States.

Longitudinal Interviews of Couples Diagnosed with Diminished Ovarian Reserve Undergoing Fragile X Premutation Testing

“…In common to both partners was verbalization of the financial burden of medical fertility treatments, as has been reported previously (Nachtigall, MacDougall, Davis, & Beyene, 2012), though this was voiced more strongly by the husbands.…”

Observed Mother– and Father–Child Interaction Differences in Families with Medically Assisted Reproduction‐Conceived Twins and Singletons

“…Consistent with national MAR user demographics (Nachtigall, MacDougall, Davis, & Beyene, ), most parents (mothers: 95.1%, fathers: 95.9%) were White and had above‐average education and incomes. For example, 83.6% of mothers and 65.2% of fathers held a bachelor's degree or higher.…”

Conversation Orientation Moderates the Relationship between Information Sharing of Medically Assisted Reproduction and Child Adjustment

“…Thirteen children (16.7%) were conceived using donor gametes (donor sperm only: n = 9; donor egg only: n = 4); four of them knew of their MAR conception. Consistent with U.S. MAR user demographics (Nachtigall, MacDougall, Davis, & Beyene, ), children came from families where most parents were White (first parents: 96.3%; second parents: 94.3%) and had above‐average education (81.2% of first parents and 69.8% of second parents with at least a bachelor's degree) and family incomes (median: $90,000–$99,999; range: $40,000 to $200,000 or more). Most families had heterosexual parents ( n = 51 families, 92.7%); four families had same‐sex female couples (7.3%).…”

“…Although caution should be exercised when generalizing results based on a sample of MAR families drawn from one U.S. university reproductive clinic, the MAR information sharing rate in this study was consistent with previously reported rates (Colpin & Soenen, ; Nekkebroeck et al., ). Sampled families also reflect demographics of U.S. MAR families (Nachtigall et al., ).…”