Our expert answers 3 Questions
I’ve been thinking about reproductive health inequities in our healthcare system. These inequities are especially apparent in policy decisions made by insurers to cover or not cover work-up and treatment for infertility.
The World Health Organization classifies infertility as a disease, and most people agree that reproduction is an important life activity. Infertility can have a significant impact on couples and can be associated with other major health conditions. For example, having male factor infertility is associated with an increased long-term risk for cancer, cardiovascular disease, and early mortality. Thus, I find it interesting that the vast majority of insurance companies exclude infertility work-up and treatment, similar to how they exclude coverage for cosmetic surgery.
Infertility treatments can be expensive, but when patients are left to pay out-of-pocket for their care, many are excluded from accessing services. Given the other conditions associated with infertility, these patients should be pulled into the healthcare system so that their diabetes and obesity, for example, can be identified early and treated. Additionally, providing insurance coverage for infertility treatments like varicocelectomy and vasectomy reversal can downgrade the intensity of the intervention required for a couple to achieve a pregnancy and lower overall costs to the healthcare system.