Redefining Infertility and Insurance Coverage

Insufficient coverage by insurance companies for fertility treatment is a distressing fact that perpetuates gender inequalities. In the U.S., only 15 states have laws requiring coverage, although an estimated 10 percent of women (over 6 million) of childbearing age struggle to get or stay pregnant. Progress is underway, but there is much more work to be done to have infertility recognized as a disease, warranting coverage.

Globally, reproductive medicine organizations have advocated for the definition of infertility as a disease that “generates disability as an impairment of function.” Infertility has been recognized as a disease for several years by the American Society for Reproductive Medicine (ASRM). However, the American Medical Association (AMA) representatives have only supported the World Health Organizations’ (WHO) designation of infertility as a disease since 2017. Other supporters include March of Dimes, International Federation of Gynecology and Obstetrics, International Federation of Fertility Societies, and the European Society of Human Reproduction and Embryology. Women’s health care providers, as well as ObGyns, can further the progress, including access to infertility care, and equality in reproductive rights.

The U.S. Supreme Court maintained infertility as a disability under the Americans with Disabilities Act (ADA) in 1998. But, that a person is not considered disabled if the limitation can be overcome by curative action. A lower court in 2000 held that while infertility is a disability, health plans provided by an employer that excludes treatment is not discriminatory if it applies to all employees under the ADA. Spotlighting gender issues in employment and long-standing inequalities concerning reproductive matters are paramount to change. Social movements of late help further the cause.

Advocacy efforts have helped to improve the understanding of the burden of infertility, gender inequalities in reproduction, and inadequate insurance coverage to date. However, it is essential to continue the demands for recognition, gender equality, and access to care.

MCRM Fertility will continue to discuss these inequities with patients, and insurance companies to encourage the coverage needed for reproductive health care. We’re devoted to keeping this issue in the limelight to serve our patients along their journey to fertility and assist wherever possible.

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