Research Reveals Ways to Improve Access to Infertility Care
ASRM19 October 2016
Many patients who need infertility care do not get it. Research presented at the American Society for Reproductive Medicine’s Scientific Congress examined several approaches to improving access to care for infertility patients.
A team from Delaware investigated whether lower doses of drugs and the use of single embryo transfer could lower costs to patients while preserving high success rates. The team enrolled 137 good prognosis patients, 54 patients underwent traditional IVF, while 83 did minimal stimulation and single embryo transfer cycles. The patients utilizing traditional IVF methods produced more eggs and their cumulative pregnancy rate was somewhat higher at 85% compared to 73% for the minimal stimulation group. However, because the cost of each treatment cycle was lower in the minimal stimulation group, the actual mean cost of each live birth was only $15,000 compared to $20,000 for the traditional IVF cohort.
Researchers from the University of Southern California took a similar approach, but examined more explicitly the cost breakdowns of various approaches over multiple cycles. They found the most cost effective approach was as many as 2 minimally stimulated IVF cycles followed by frozen embryo cycles. They found the cost difference between traditional and modified natural stimulation cycles to be around $7000.
As clinical researchers strive to bring down the cost of IVF, other barriers remain. Only a minority of US health insurance plans offer full infertility coverage. Data from an infertility benefits management firm shows that education of employers about clinical and technological advances in fertility treatments, including Single Embryo Transfer (SET) can increase access to care for employees and hold down related costs to the employers. Data was collected from two companies who began offering an infertility benefit in January of 2016. First quarter data indicated a utilization rate of about 1%, roughly 4 times the national average. However nearly 80% of the cycles utilized SET and no multiple gestations were reported. Given the very high costs of treating high order multiple births, it is estimated this saved the employers as much as $4 million.
Non-medical and non-economic actors have a role to play in promoting access to care as well. Researchers from Yale found that large numbers (72%) of women with a history of infertility reported praying, higher number than sought medical help (53%). Similarly, more women (19%) consulted a spiritual leader than went to a support group (12%)or counselor (9%). These numbers were higher for African American and Hispanic women than Caucasian women.
“Improving patient access to care is a vital issue for ASRM. These research studies show that our members are striving to explore scientific, economic and social solutions to improving access.” Said Owen K. Davis, MD, President of the American Society for Reproductive Medicine