By Brooke Goff
1978 is a good year for all expectant parents. This is when ‘test tube baby’ Louise Brown was born through in vitro fertilization (IVF) in England. Three years later, the first IVF baby was born in the US.
Originally yielding a single-digit success rate, IVF is now effective in almost 50% of cases, accounting for millions of births worldwide. Despite this positive rate, only 15 states currently have laws requiring health insurance plans to cover infertility treatment, thus denying the path to parenthood for countless couples.
Infertility is a common challenge affecting millions of Americans in the United States and can have important implications for a woman’s well-being. According to the most recent survey by the National Survey of Family Growth, approximately 9% of married women ages 15 to 49 are believed to be experiencing some form of infertility. For these women in same-sex marriages, IVF is a scientific necessity if either partner wishes to experience pregnancy and motherhood.
Every woman deserves the right to reproduce, and infertility adds exorbitant costs, extreme anxiety, and short-term tension between couples going through it. There needs to be an overhaul of the IVF system so that assisted reproductive technology is a more inclusive, accessible and accepted decision for all.
As an IVF advocate and patient, some innovative ideas include:
Abolish the waiting period for same-sex couples:
There are approximately 1.2 million same-sex households in the United States, according to recently released Census Bureau data. Of these couples, 53% are between women. That’s a total of 636,000 women who could potentially become pregnant.
As of October 2023, the American Society for Reproductive Medicine has changed its definition of infertility, which is now “a disease, condition, or condition characterized by any of the following: an inability to achieve a successful pregnancy based on medical, sexual, and reproductive history, age, physical findings, diagnostic tests, or any combination of these factors.
This is a huge change for the better, LGBTQ inclusive, as it identifies homosexuality as a likely cause of infertility. We must now take the next natural step by enabling same-sex couples to immediately access IVF treatment, rather than subjecting them to the traditional 12-month waiting period, as is often required by their health insurance. This change will focus on the growth of our future generations and allow parents, regardless of their sexual orientation, the opportunity to take on the journey of parenthood as soon as they choose.
Require private insurers and employers to offer comprehensive IVF benefits:
Many patients cannot access fertility services because of the high cost and limited coverage by private insurance and Medicaid. Although some health insurances cover basic infertility procedures in some states, they have requirements that are impossible for some couples. Health insurance generally does not cover surrogacy, adoption, egg collection, donor eggs, or donor sperm. Many people have to pay out of pocket, and costs can vary widely depending on the patient, state of residence, provider, and specific insurance plan. Many patients require several rounds of IVF treatment before becoming pregnant, which can burden patients with additional unforeseen costs. According to FertilityIQ and GoodRX, the average total cost of infertility treatment in America in 2023 ranges between $20,000 and $30,000.
Requiring all states to mandate at least one private insurance plan and companies with more than 100 employees to offer coverage for assisted reproductive technology is a win-win for both the couple and the corporation. Although the cost of fertility treatment can be expensive for those without coverage, the cost of coverage for employer-provided fertility benefits may be minimal.
Analyzing data from several northeastern states, where fertility rates are higher than other parts of the country, suggests that mandatory coverage does not appear to significantly increase company-sponsored health insurance. In fact, CT, MA and RI have mandated infertility benefits for over 30 years and estimate the cost at less than 1% of premiums.
Additionally, employees are the lifeblood of any organization and business owners, regardless of size, should also invest in them, especially in the area of family planning and creation. Comprehensive coverage that includes mental health counseling, customized infertility design and implementation, access to countless clinics across the US, discounted coverage for surrogacy, adoption, egg retrieval, donor eggs, donor sperm and postpartum breastfeeding services, such as overnight doulas and postpartum services, would bring comfort to couples going through this very uncertain process.
Overturning Alabama Decision Criminalizing IVF:
There is a new legal hurdle for couples facing infertility. The Alabama Supreme Court ruled on February 16, 2024 that embryos created through IVF should be considered children and have the same rights. This decision will take away pregnancy opportunities and create liabilities for both parents and clinics. The decision should be appealed.
An embryo is a promise of pregnancy, not an actual pregnancy. In order for an embryo to lead to birth, the female body must successfully implant a healthy embryo and hormonal balance must be achieved for the pregnancy to be viable. An embryo stage is too early to be considered to have the same rights as a child. The destruction of embryos should not be criminalized to the same extent as the destruction of a live baby.
This decision will ultimately affect the entire health insurance industry in America, as liability costs will increase premiums for everyone—not just those facing infertility.
Brooke Gough, Esq. is the founder and CEO of Goff Law Group, a woman-owned and operated personal injury law firm.
