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The Burden of Infertility, Treatment Options, and Insurance Coverage: A Policy Brief and Future Directions

Su, Xin (2022) The Burden of Infertility, Treatment Options, and Insurance Coverage: A Policy Brief and Future Directions. Master Essay, University of Pittsburgh.

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Infertility is a public health issue that affects about 10% of the world’s population, causing a substantial global economic burden and a severe socio-psychological burden. Various physical and psychological reasons can cause infertility. In addition, unhealthy lifestyles and habits can also contribute to infertility. With socio-economic development and changes in people’s lifestyles, the leading causes of infertility have changed from infectious factors to increased pressure and women’s delayed fertility. Moreover, male factor infertility must be given attention. Infertility can be treated with medicine, surgery, intrauterine insemination (IUI), or assisted reproductive technology (ART). However, infertility treatments can be quite expensive, and many health insurance plans do not cover infertility diagnoses or treatments. Nineteen states in the United States have enacted some form of the infertility insurance mandate. This paper discusses the burden of infertility in the United States, its etiology, treatment options and associated costs of infertility, infertility insurance coverage laws in the United States and their effects. The issue of fertility preservation is also addressed. Recommendations for national-level and state-level infertility insurance policies are based on three categories: no insurance mandate, insurance mandates for women only, and insurance mandates for both men and women. This paper also proposes that attention be paid to insurance coverage for male infertility and balanced with insurance coverage for female infertility. The limitations of this paper are also discussed.

Public Health Significance: Although infertility affects only 10% of the world’s population, the social and psychological burden caused by it is no less than that of malignant tumors and heart diseases. Infertility insurance mandates are critical due to the high cost and out-of-pocket expense of infertility treatments. The policy recommendations made in this paper for different states will have significant reference value for policymakers, insurance providers, health professionals, and patients toward a more accessible and high-quality health care service for infertility.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Su, Xinxis83@pitt.eduxis830000-0001-9402-1272
ContributionContributors NameEmailPitt UsernameORCID
Thesis advisorJarlenski, Marianmarian.jarlenski@pitt.edumarian.jarlenskiUNSPECIFIED
Committee MemberTerry, Marthamaterry@pitt.edumaterryUNSPECIFIED
Committee MemberRohrer, Wesleywmrun@pitt.eduwmrunUNSPECIFIED
Date: 1 July 2022
Date Type: Completion
Submission Date: 19 June 2022
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 56
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Health Policy & Management
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: infertility, fertility, insurance coverage, assisted reproductive technology (ART), infertility mandate
Date Deposited: 01 Jul 2022 20:09
Last Modified: 01 Jul 2022 20:09


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