In vitro fertilization availability and utilization in the United States: a study of demographic, social, and economic factors.
OBJECTIVE
To characterize the demographic correlates of IVF availability and utilization.


METHODS
Demographic analysis of public data.


METHODS
Each of the 50 states in the United States was used as a unit of analysis.


METHODS
Patients undergoing IVF, as demographically estimated.


METHODS
Publicly available data were collected through the Society for Assisted Reproductive Technology and the Centers for Disease Control. The US Census Bureau data were collected by using software available from the Centers for Disease Control.


METHODS
The number of physicians performing IVF and the number of IVF cycles per 100,000 reproductive-age women were used to estimate IVF availability and utilization.


RESULTS
In 2005, 1,031 providers performed 98,242 fresh IVF cycles in 430 centers. Overall availability was 2.5 IVF physicians per 100,000, and utilization was 236 IVF cycles per 100,000. Availability and utilization of IVF were highly correlated. Mean IVF availability and utilization were significantly higher in states with IVF insurance coverage. In adjusted analyses, IVF availability correlated positively with mandated insurance coverage, percentage of single persons, and median income. Utilization of IVF correlated with IVF availability, percentage urbanization, and percentage of individuals >or=25 years of age who had a bachelor's degree.


CONCLUSIONS
Lower rates of IVF utilization in some states are correlated with a lack of insurance coverage and decreased availability of physicians providing this service.
Hammoud
Ahmad O
AO
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Utah School of Medicine, Salt Lake City, Utah 84132, USA. ahmad.hammoud@hsc.utah.edu
Gibson
Mark
M
Stanford
Joseph
J
White
George
G
Carrell
Douglas T
DT
Peterson
Matthew
M
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D019458:Insurance Coverage; D015999:Multivariate Analysis; D014481:United States