Insurance coverage and in vitro fertilization outcomes: a U.S. perspective

Objective To compare the impact of mandated IVF insurance coverage on ET practices and resulting multiple pregnancy rates. Design Retrospective analysis of all fresh, nondonor IVF cycles performed in the United States in 2006. Setting United States. Patient(s) A total of 91,753 fresh, nondonor IVF cycles in the United States. Intervention(s) None. Main Outcome Measure(s) Pregnancy rate, live-birth rate, embryos transferred, multiple pregnancy rate. Result(s) 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