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

OBJECTIVE

To assess attitudes and factors that influence public opinion in the general US population toward insurance coverage and provision of infertility care to lower income patients.

DESIGN

Cross-sectional survey.

SETTING

Online.

PATIENTS

A nationally representative sample of US residents.

INTERVENTIONS

Questionnaire with multiple choice and open response questions.

MAIN OUTCOME MEASURES

Public attitudes toward in vitro fertilization and infertility care coverage for lower income patients.

RESULTS

A total of 1,027 (90.2%) participants completed the survey, among whom 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 a disease. Over half of the respondents (568, 55.3%) supported private insurance coverage of infertility services, including for in vitro fertilization. Most respondents, 735 (71.6%) believed that the prevalence and psychosocial impact of infertility were equal among the lower and higher income people. The majority of respondents with an opinion (512, 67.6%) believed that doctors should provide infertility treatments regardless of the income level of the patients. Of supporters, 40.1% believed in the right to have a family regardless of income, and 38.2% believed that doctors had a social responsibility to provide infertility services. After adjusting for covariates, age <45 years, noncollege graduates, desiring more children, believing that infertility was a disease, and residence in the Northeast region remained significant predictors for support of private insurance coverage.

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.