Fertility Treatments Becoming More Common, Costly To Health Care System, CDC Says

Main Category: Fertility
Article Date: 17 Jun 2009 - 7:00 PDT

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The number of assisted reproduction procedures, such as in vitro fertilization, continues to increase at a rapid pace, with half of the 54,656 infants born in 2006 being twins, triplets or higher multiples, according to a series of Centers for Disease Control and Prevention reports, HealthLeaders Media reports. Since 2001, the number of live-birth deliveries -- which includes those in which at least one infant was born -- as the result of assisted reproductive technology increased by 41%, and the number of infants born as a result increased by 34%, according to CDC. ART services are offered at 483 medical centers, compared with 421 in 2001.

According to CDC, ART procedures are more likely to result in multiple births, which produce higher rates of complication in the infants, such as prematurity, low birthweight and disability. CDC said that the cost of treating complications resulting from ART pregnancies totaled $1 billion in 2005, presenting an economic burden to hospitals and payers. The American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology recommend that doctors transfer one embryo in women younger than age 35, one or two in women ages 35 to 37, no more than three embryos in women ages 38 to 40 and up to five in older women and "extraordinary circumstances." However, CDC reported that about 16% of ART procedures since 2001 involved four or more embryos, and 5% involved five or more embryos, indicating that these guidelines were not widely followed. According to CDC, "In certain states, ART procedures are not covered by insurance carriers, and patients might feel pressured to maximize the opportunity for live-birth delivery by transferring multiple embryos." The report also noted that physicians might be implanting more embryos to increase the percentage of total live-birth deliveries by their patients. The report said that to "minimize the adverse maternal and child health effects associated with multiple pregnancies, ongoing efforts to limit the number of embryos transferred in each ART procedure should be continued and strengthened."

Many hospitals consider ART a lucrative field because most patients undergoing the procedures have private insurance or pay out of pocket. However, health plans pass on the costs of complications to employers and the insured in the form of higher premiums, HealthLeaders Media reports. Thomas Moore, director of Obstetrical Services at the University of California-San Diego, said, "Even though private insurance pays a large percentage of the cost of caring for these newborns, it can be expensive for the health insurance industry overall," adding, "At $2,000 to $3,000 a day for intensive care, which can continue three and four months, that's a cost that raises premiums across the board" (Clark, HealthLeaders Media, 6/12).

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