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State Insurance Mandates and Multiple Birth Rates After In Vitro Fertilization.

Publication ,  Journal Article
Provost, MP; Thomas, SM; Yeh, JS; Hurd, WW; Eaton, JL
Published in: Obstet Gynecol
December 2016

OBJECTIVE: To examine the association between state-mandated insurance coverage for in vitro fertilization (IVF) and the incidence of multiple birth while controlling for differences in baseline patient characteristics. METHODS: We conducted a retrospective cohort study using the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System from 2007 to 2011 to examine the association between state-mandated insurance coverage for IVF and the incidence of multiple birth while controlling for differences in baseline patient characteristics. Analyses were stratified according to patient age and day of embryo transfer (3 or 5). RESULTS: Of the 173,968 cycles included in the analysis, 45,011 (25.9%) were performed in mandated states and 128,957 (74.1%) in nonmandated states. The multiple birth rate was significantly lower in mandated states (29.0% compared with 32.8%, adjusted odds ratio [OR] 0.87, 99.95% confidence interval [CI] 0.80-0.94). After stratification, this association remained statistically significant only in women younger than 35 years old who underwent transfer on day 5 (33.1% compared with 38.6%, adjusted OR 0.81, 99.95% CI 0.71-0.92). Among women younger than 35 years with day 5 transfer, the elective single embryo transfer rate was significantly higher in mandated states (21.8% compared with 13.1%, adjusted OR 2.36, 99.95% CI 2.09-2.67). CONCLUSION: State-mandated insurance coverage for IVF is associated with decreased odds of multiple birth. This relationship is driven by increased use of elective single embryo transfer among young women undergoing day 5 transfer.

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Published In

Obstet Gynecol

DOI

EISSN

1873-233X

Publication Date

December 2016

Volume

128

Issue

6

Start / End Page

1205 / 1214

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Pregnancy, Multiple
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Insurance, Health
  • Insurance Coverage
  • Humans
  • Fertilization in Vitro
  • Female
  • Embryo Transfer
 

Citation

APA
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Provost, M. P., Thomas, S. M., Yeh, J. S., Hurd, W. W., & Eaton, J. L. (2016). State Insurance Mandates and Multiple Birth Rates After In Vitro Fertilization. Obstet Gynecol, 128(6), 1205–1214. https://doi.org/10.1097/AOG.0000000000001733
Provost, Meredith P., Samantha M. Thomas, Jason S. Yeh, William W. Hurd, and Jennifer L. Eaton. “State Insurance Mandates and Multiple Birth Rates After In Vitro Fertilization.Obstet Gynecol 128, no. 6 (December 2016): 1205–14. https://doi.org/10.1097/AOG.0000000000001733.
Provost MP, Thomas SM, Yeh JS, Hurd WW, Eaton JL. State Insurance Mandates and Multiple Birth Rates After In Vitro Fertilization. Obstet Gynecol. 2016 Dec;128(6):1205–14.
Provost, Meredith P., et al. “State Insurance Mandates and Multiple Birth Rates After In Vitro Fertilization.Obstet Gynecol, vol. 128, no. 6, Dec. 2016, pp. 1205–14. Pubmed, doi:10.1097/AOG.0000000000001733.
Provost MP, Thomas SM, Yeh JS, Hurd WW, Eaton JL. State Insurance Mandates and Multiple Birth Rates After In Vitro Fertilization. Obstet Gynecol. 2016 Dec;128(6):1205–1214.

Published In

Obstet Gynecol

DOI

EISSN

1873-233X

Publication Date

December 2016

Volume

128

Issue

6

Start / End Page

1205 / 1214

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Pregnancy, Multiple
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Insurance, Health
  • Insurance Coverage
  • Humans
  • Fertilization in Vitro
  • Female
  • Embryo Transfer