title: Expensive but worth it: older parents' attitudes and opinions about the costs and insurance coverage for in vitro fertilization.
abstract: OBJECTIVE
  To describe older parents' attitudes and opinions about the costs and insurance coverage for IVF.
  
  
  METHODS
  Qualitative interview study.
  
  
  METHODS
  Two Northern California IVF practices.
  
  
  METHODS
  Sixty women and 35 male partners in which the woman had delivered her first child after the age of 40 years using IVF.
  
  
  METHODS
  Two in-depth interviews over 3 months.
  
  
  METHODS
  Thematic analysis of interview transcripts.
  
  
  RESULTS
  We found that although the costs of IVF were perceived as high, even by those with insurance or who could afford them, the cost of IVF relative to other expenses in life was dwarfed by the value attributed to having a child. Women were twice as likely as men to support insurance coverage for IVF. Both men and women with complete or partial IVF insurance coverage were more likely to support insurance than those without coverage. There was a broad range of attitudes and opinions about the appropriateness of IVF insurance coverage, which addressed questions of age, gender equality, reproductive choice, whether infertility is a medical illness, and the role of personal and societal economic equity and responsibility.
  
  
  CONCLUSIONS
  Despite a generally favorable opinion about the appropriateness of insurance coverage by those who have successfully undergone IVF treatment, the affordability of IVF remains an unresolved dilemma in the United States.
authors: Institute for Health and Aging, University of California, San Francisco, San Francisco, California 94118, USA. Robert.Nachtigall@ucsf.edu
authors: Robert D
authors: RD
authors: Nachtigall
authors: Kirstin
authors: K
authors: MacDougall
authors: Anne C
authors: AC
authors: Davis
authors: Yewoubdar
authors: Y
authors: Beyene
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D002140:California; D005260:Female; D005307:Fertilization in Vitro / Q000191:economics*; D017048:Health Care Costs; D006801:Humans; D019458:Insurance Coverage / Q000191:economics*; D007348:Insurance, Health / Q000191:economics*; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D012945:Social Values; D012959:Socioeconomic Factors