PD18-11 IMPACT OF STATE IN-VITRO FERTILIZATION MANDATES ON MALE INFERTILITY CARE

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD18-11 IMPACT OF STATE IN-VITRO FERTILIZATION MANDATES ON MALE INFERTILITY CARE James Dupree, Rodney L. Dunn, Phyllis Yan, David Suh, Erica Marsh, Edward C. Norton, Vanessa Dalton, and Marissa S. Weiss James DupreeJames Dupree More articles by this author , Rodney L. DunnRodney L. Dunn More articles by this author , Phyllis YanPhyllis Yan More articles by this author , David SuhDavid Suh More articles by this author , Erica MarshErica Marsh More articles by this author , Edward C. NortonEdward C. Norton More articles by this author , Vanessa DaltonVanessa Dalton More articles by this author , and Marissa S. WeissMarissa S. Weiss More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003273.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: By 2019, 11 states had passed laws mandating insurance coverage for infertility care, including in-vitro fertilization (IVF). These mandates vary in their coverage for male infertility care, with five states (AR, HI, IL, MD, RI) mandating IVF coverage but not coverage for male infertility care. Our objective was to evaluate the use of IVF and three common male infertility procedures (varicocelectomy, testicular/epididymal biopsy, and vasectomy reversal) in three groups of states: 1) states mandating IVF coverage and male infertility care, 2) states mandating IVF coverage but not male infertility care, and 3) states without IVF mandates. METHODS: We obtained nationwide insurance claims from over 80 million individuals from 2003 to 2019 from Optum® ClinformaticsTM Data Mart. We identified IVF cycles using the Current Procedural Terminology (CPT) code for oocyte retrieval and excluded oocyte retrievals performed for fertility preservation. We identified varicocelectomy, testicular/epididymal biopsy, and vasectomy reversal using their respective CPT codes. States were categorized into three groups: 1) states mandating IVF coverage and male infertility care (CT, MA, NJ, NY, DE 2018-19, UT 2018-19); 2) states mandating IVF coverage but not male infertility care (AR, HI, IL, MD, RI); and 3) all remaining states, including both DE and UT from 2003-2017. Within each group of states, we calculated the use rates and 95% confidence intervals (CIs) of IVF cycles per 100,000 women aged 21-44 and of varicocelectomy, testicular/epididymal biopsy, and vasectomy reversal per 100,000 men. RESULTS: IVF use was highest in Group 1 states and lowest in Group 3 states (Table 1). Varicocelectomy and testicular/epididymal biopsy use was 43% to 89% higher in Group 1 states than in Group 2 and 3 states. Use of vasectomy reversal—a procedure not typically covered by insurance regardless of state mandates—was only 14% higher in Group 1 states than in Group 3 states. The overall use of male infertility procedures was similar in Group 2 and 3 states. CONCLUSIONS: There is decreased use of male infertility procedures in states whose IVF mandates do not include coverage for male infertility care. Policymakers considering new state mandates for IVF should include coverage for male infertility care to facilitate access to effective male infertility treatments. Source of Funding: Eunice Kennedy Shriver National Institute of Child Health & Human Development - 1R01HD103603-01A1 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e507 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information James Dupree More articles by this author Rodney L. Dunn More articles by this author Phyllis Yan More articles by this author David Suh More articles by this author Erica Marsh More articles by this author Edward C. Norton More articles by this author Vanessa Dalton More articles by this author Marissa S. Weiss More articles by this author Expand All Advertisement PDF downloadLoading ...