title: Insurance coverage and in vitro fertilization outcomes: a U.S. perspective.
abstract: OBJECTIVE
  To compare the impact of mandated IVF insurance coverage on ET practices and resulting multiple pregnancy rates.
  
  
  METHODS
  Retrospective analysis of all fresh, nondonor IVF cycles performed in the United States in 2006.
  
  
  METHODS
  United States.
  
  
  METHODS
  A total of 91,753 fresh, nondonor IVF cycles in the United States.
  
  
  METHODS
  None.
  
  
  METHODS
  Pregnancy rate, live-birth rate, embryos transferred, multiple pregnancy rate.
  
  
  RESULTS
  Overall, nonmandated states had a significantly higher pregnancy rate (38.8% vs. 35%) and live-birth rate (32.2% vs. 29.1%) than mandated states. Nonmandated states also had a significantly higher twin rate (28.1% vs. 26%) and triplet rate (3.9% vs. 3.4%). The average number of embryos transferred was also significantly higher in nonmandated states (2.6 vs. 2.2). These findings were more pronounced in the <35 and 35-37 age groups.
  
  
  CONCLUSIONS
  In the last 8 years, despite a reduction in the average number of embryos transferred and multiple pregnancy rates, there is a continued association between mandated IVF coverage, the transfer of fewer embryos, and lower rates of multiple pregnancies and births, particularly in the younger age groups.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, Yale Fertility Center, New Haven, Connecticut 06510, USA
authors.forename: J Ryan
authors.initials: JR
authors.lastname: Martin
authors.forename: Jason G
authors.initials: JG
authors.lastname: Bromer
authors.forename: Denny
authors.initials: D
authors.lastname: Sakkas
authors.forename: Pasquale
authors.initials: P
authors.lastname: Patrizio
mesh_terms: D000328:Adult; D017677:Age Distribution; D004624:Embryo Transfer / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D005307:Fertilization in Vitro / Q000191:economics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D013219:State Government; D014310:Triplets; D014427:Twins; D014481:United States / Q000453:epidemiology