title: Infertility services and managed care.
abstract: The birth of the McCaughey septuplets in Iowa in November 1997 brought issues of fertility assistance and their potential outcomes to worldwide attention. This Pergonal-stimulated multiple pregnancy ended successfully, but not without health hurdles and economic consequences for the new siblings and their family. This article reviews the general situation surrounding infertility services and, within the current debate of epidemiological, economic, legal and social issues, posits that managed care may be able to make greater strides than the present fee-for-service system in providing more accessible and comprehensive care to the 5.3 million US citizens at risk for infertility. Our conclusions suggest that managed care plans for infertility can aid in assuring quality and decreasing unnecessary costs. Managed care organizations should take the lead in providing infertile couples with an organized, humanistic approach that is mindful of the attending social issues. On May 5, 1997, a US District court in Chicago ruled that infertility fits the definition of a disability, and thus is subject to the antidiscrimination enforcement under the Americans with Disabilities Act.
authors.affiliation: College of Pharmacy, University of Illinois at Chicago 60612, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Bron
authors.forename: J W
authors.initials: JW
authors.lastname: Salmon
mesh_terms: D000367:Age Factors; D002985:Clinical Protocols; D006233:Persons with Disabilities; D004651:Employment; D017407:Family Leave; D005260:Female; D006801:Humans; D007246:Infertility / Q000628:therapy*; D008329:Managed Care Programs / Q000458:organization & administration*; D011247:Pregnancy; D012017:Referral and Consultation; D018456:Reproductive Medicine / Q000458:organization & administration* / Q000592:standards; D012959:Socioeconomic Factors; D014481:United States