Suh David, Yan Phyllis, Dunn Rodney L, Norton Edward C, Dalton Vanessa K, Marsh Erica E, Weiss Marissa S, Dupree James M
Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan.
Department of Urology, University of Michigan, Ann Arbor, Michigan.
Fertil Steril. 2025 Jun;123(6):1029-1038. doi: 10.1016/j.fertnstert.2024.12.015. Epub 2024 Dec 12.
To evaluate in vitro fertilization (IVF) cycles covered by health insurance using a national commercial claims database and validate key clinical events against national IVF registries.
Retrospective cohort study.
US women aged 20-44 years who underwent IVF from 2005-2020 in Optum's deidentified Clinformatics Data Mart Database (CDM).
Undergoing IVF.
In vitro fertilization cycles and rates of pregnancies (inclusive of losses and terminations), live births, and live birth types (e.g., singleton, twin, and triplet or higher-order).
We identified more than 3,000 IVF cycles in each year from 2005-2020 within CDM. When comparing our rates of clinical outcomes with external benchmark data, the results were similar across all the years of our study. For example, in 2020, the percentages of pregnancies after first embryo transfer were 62.03% (95% confidence interval [CI], 59.48-64.47) in CDM and 64.96% in data from the Society for Assisted Reproductive Technology (SART). The rates of live birth after first embryo transfer were 44.58% (95% CI, 41.90-47.21) in CDM in 2020 and 46.95% in SART in 2020. The rate of singleton births was 94.17% (95% CI, 92.24-96.10) in CDM in 2020, and this rate was 94.37% in SART in 2020. For twin births, the rates were 5.48% (95% CI, 3.60-7.35) in CDM in 2020 and 5.46% in SART in 2020. The rates of triplet or higher-order births were 0.35% (95% CI, 0.00-0.84) in CDM in 2020 and 0.17% in SART in 2020.
We found that CDM can be used to accurately identify IVF cycles covered by insurance and key clinical outcomes such as rates of pregnancies, live births, and live birth types, and our reported rates were similar to national IVF clinical registry data. Our findings support that CDM is a robust data source to conduct research about IVF insurance coverage and can accurately evaluate clinical outcomes resulting from IVF. Policymakers who are considering insurance coverage for IVF can use CDM to model and measure the impact of new or existing policies for IVF insurance coverage.
利用全国商业索赔数据库评估医疗保险覆盖的体外受精（IVF）周期，并对照全国IVF登记处验证关键临床事件。
回顾性队列研究。
2005年至2020年在美国Optum的去识别化临床信息数据集市数据库（CDM）中接受IVF的20至44岁美国女性。
接受IVF。
体外受精周期以及妊娠率（包括流产和终止妊娠）、活产率和活产类型（如单胎、双胎和三胎或多胎）。
我们在CDM中识别出2005年至2020年每年超过300０个IVF周期。将我们的临床结局发生率与外部基准数据进行比较时，在我们研究的所有年份中结果相似。例如，2020年，CDM中首次胚胎移植后的妊娠率为62.03%（95%置信区间[CI]，59.48 - 64.47），辅助生殖技术协会（SART）数据中的这一比例为64.96%。2020年CDM中首次胚胎移植后的活产率为44.58%（95%CI，41.90 - 47.21），2020年SART中的这一比例为46.95%。2020年CDM中单胎出生率为94.17%（95%CI，92.24 - 96.10），2020年SART中的这一比例为94.37%。对于双胎分娩，2020年CDM中的比例为5.48%（95%CI，3.60 - 7.35），2020年SART中的比例为５.46%。2020年CDM中三胎或多胎出生率为0.35%（95%CI，0.00 - 0.84），2020年SART中的比例为0.17%。
我们发现CDM可用于准确识别保险覆盖的IVF周期以及关键临床结局，如妊娠率、活产率和活产类型，并且我们报告的发生率与全国IVF临床登记数据相似。我们的研究结果支持CDM是开展IVF保险覆盖研究的可靠数据源，并且能够准确评估IVF产生的临床结局。考虑IVF保险覆盖的政策制定者可以使用CDM来模拟和衡量IVF保险覆盖新政策或现有政策的影响。
