Public attitudes in the United States toward insurance coverage for in vitro fertilization and the provision of infertility services to lower income patients

ABSTRACT: Objective To assess attitudes and factors that influence public opinion in the general U.S. population toward insurance coverage and provision of infertility care to lower income patients. Design Cross-sectional survey Setting Online Patient(s) A nationally representative sample of U.S. residents. Intervention(s) Questionnaire with multiple choice and open-response questions. Main outcome measure(s) Public attitudes towards IVF and infertility care coverage in lower income patients. Results A total of 1,027 (90.2%) participants completed the survey. 620 (60.4%) had private insurance, 275 (26.8%) had Medicare/Medicaid, and 56 (5.5%) were uninsured. The majority (916, 89.2%) did not consider infertility to be a disease. Over half (568, 55.3%) supported private insurance coverage of infertility services including IVF. 189 (18.4%) did not think it should be covered. 735 (71.6%) people thought the prevalence and psychosocial impact of infertility were equal among lower and higher income people. The majority of respondents with an opinion (512, 67.6%) believed that doctors should provide infertility treatments regardless of income level of patients. Of supporters, 40.1% believed in the right to have a family regardless of income, and 38.2% believed doctors had a social responsibility to provide infertility services. After adjusting for covariates, age Conclusions Public perception of infertility as a disease is one of the strongest predictors of support for insurance coverage for infertility services, underscoring the need for enhanced advocacy and education in the general public.