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女性医师不孕:保险覆盖不足。

Female physician infertility: the lack of adequate insurance coverage.

机构信息

Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, MO.

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, MO.

出版信息

Am J Obstet Gynecol. 2023 Mar;228(3):306-310. doi: 10.1016/j.ajog.2022.08.049. Epub 2022 Sep 5.

DOI:10.1016/j.ajog.2022.08.049
PMID:36067804
Abstract

There is a recent decrease in fertility rates among the general population in the United States. Female physicians, who are seeking assisted reproductive technology at growing rates often because of delayed childbearing while completing medical training, are included in this statistic. With more than 340,000 practicing female physicians within the United States, female physician infertility is especially relevant. However, despite the increasing number of female physicians seeking assisted reproductive technology, there is a lack of access to adequate insurance coverage for this higher-risk patient subset. This commentary reviewed the importance of increasing infertility rates among female physicians, the associated economic burden, limited insurance coverage, and disparities in access to infertility insurance coverage. Recent studies suggest that up to 25% of female physicians are seeking assisted reproductive technology. Currently, 1 cycle of assisted reproductive technology, or egg retrieval, is estimated at approximately $19,000, with many people needing multiple cycles. Many top academic institutions do not offer enough infertility benefits to cover 1 egg retrieval cycle and the often prerequisite, less invasive procedures. Among those seeking oocyte or embryo cryopreservation for elective fertility preservation, few institutions offer coverage. Addressing and highlighting limited and variable institutional infertility coverage are crucial to gaining equal and accessible reproductive care for female physicians.

摘要

美国普通人群的生育率最近有所下降。由于在完成医学培训期间推迟生育,越来越多的女性医生也在寻求辅助生殖技术,她们也包括在这一统计数据中。在美国,有超过 34 万名执业女性医生,女性医生的不孕不育问题尤其突出。然而,尽管越来越多的女性医生在寻求辅助生殖技术,但她们获得足够的保险覆盖的机会却很少,而这部分人属于高风险患者群体。本评论文章回顾了女性医生不孕不育率上升的重要性、相关的经济负担、有限的保险覆盖范围以及在获得不孕不育保险覆盖方面的差异。最近的研究表明,多达 25%的女性医生在寻求辅助生殖技术。目前,一次辅助生殖技术(即取卵)的费用估计约为 19000 美元,而许多人需要多个周期。许多顶尖的学术机构提供的不孕不育福利不足以支付一次取卵周期的费用,以及通常是必要的、侵入性较小的程序的费用。在那些寻求卵母细胞或胚胎冷冻保存以进行选择性生育力保存的人中,很少有机构提供这种服务。解决和强调机构在不孕不育方面的有限和可变的覆盖范围,对于为女性医生提供平等和可获得的生殖护理至关重要。

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Female physician infertility: the lack of adequate insurance coverage.女性医师不孕:保险覆盖不足。
Am J Obstet Gynecol. 2023 Mar;228(3):306-310. doi: 10.1016/j.ajog.2022.08.049. Epub 2022 Sep 5.
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Association of state insurance coverage mandates with assisted reproductive technology care discontinuation.州保险覆盖范围要求与辅助生殖技术护理的终止有关。
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The impact of insurance mandates on donor oocyte utilization: an analysis of 39,338 donor oocyte cycles from the Society for Assisted Reproductive Technology registry.保险授权对供卵使用的影响:对辅助生殖技术协会注册处 39338 个供卵周期的分析。
Am J Obstet Gynecol. 2022 Dec;227(6):877.e1-877.e11. doi: 10.1016/j.ajog.2022.07.024. Epub 2022 Jul 19.
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National survey of the Society for Assisted Reproductive Technology membership regarding insurance coverage for assisted reproductive technologies.国家对辅助生殖技术学会会员的调查,了解辅助生殖技术的保险覆盖范围。
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State-mandated insurance coverage is associated with the approach to hydrosalpinges before IVF.国家规定的保险覆盖范围与体外受精前处理输卵管积水的方法有关。
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Assisted reproductive technology use, embryo transfer practices, and birth outcomes after infertility insurance mandates: New Jersey and Connecticut.不孕症保险授权后的辅助生殖技术使用、胚胎移植实践及出生结局:新泽西州和康涅狄格州
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Physician infertility: a structured literature review.医师不孕:系统文献回顾。
J Assist Reprod Genet. 2024 Sep;41(9):2227-2235. doi: 10.1007/s10815-024-03216-4. Epub 2024 Aug 2.
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Publicly available information about fertility benefits for trainees at medical schools in the US.美国医学院实习生的生育福利公开信息。
J Assist Reprod Genet. 2023 Jun;40(6):1313-1316. doi: 10.1007/s10815-023-02849-1. Epub 2023 Jun 16.