title: Fertility treatment decision-making: the effect of insurance coverage for fertility medications.
abstract: OBJECTIVE
  To analyze the perceived impact of insurance coverage for fertility medications on patients' fertility treatment decision-making.
  
  
  METHODS
  We conducted a cross-sectional study involving a patient survey and chart review of women at a Canadian university-affiliated fertility centre. The primary outcome was to determine whether women with self-reported insurance coverage for fertility medications perceived the impact of insurance coverage for fertility medications differently from women without coverage or those who do not know their extent of coverage. Secondary outcomes included differences between groups in the perceived impact of insurance coverage for fertility medications on specific treatment decisions and the type of fertility treatments undergone by patients. Data collected from the survey and chart review were analyzed using chi-square tests.
  
  
  RESULTS
  More women without insurance ranked insurance coverage as having a large impact on the decision to undergo fertility treatment than women in the other groups, although this was not statistically significant. Significantly more women without insurance coverage ranked all specific treatment decisions except for the number of IVF cycles as having a large impact than did women in the other groups.
  
  
  CONCLUSIONS
  Women perceive that having insurance coverage for fertility medications affects the decision to undergo fertility treatment. Women without insurance are more likely to perceive that insurance coverage affects specific fertility treatment decisions than women with insurance or women who do not know whether they have insurance.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON.
authors.forename: Claire Ann
authors.initials: CA
authors.lastname: Jones
authors.affiliation: Department of Renewable Resources, University of Alberta, Edmonton AB.
authors.forename: Laura
authors.initials: L
authors.lastname: Gray
authors.affiliation: Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto ON.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Liu
mesh_terms: D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D005299:Fertility Agents / Q000191:economics*; D005307:Fertilization in Vitro / Q000191:economics; D019538:Health Care Surveys; D006801:Humans; D007246:Infertility / Q000628:therapy*; D019458:Insurance Coverage; D007348:Insurance, Health; D009864:Ontario; D027724:Reproductive Techniques, Assisted / Q000191:economics*
chemical_list: D005299:Fertility Agents