A possible infertility game-changer
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A new, more expansive definition of "infertility" could lead to more help for Massachusetts residents who want to have children later.
Why it matters: The new definition could lead to broader insurance coverage of fertility services like egg freezing and in vitro fertilization for all people who need help starting families, regardless of their age, sexual orientation, gender identity or medical history.
What's happening: The American Society for Reproductive Medicine (ASRM) now defines infertility as the inability to get pregnant because of the patient's medical, sexual and reproductive history, age, physical findings and diagnostic testing, writes Axios' Carly Mallenbaum.
- It also defines infertility as the need for medical intervention such as donor eggs or sperm to achieve pregnancy.
- The ASRM also retained the original criteria: when a man and woman can't get pregnant after a year of unprotected intercourse or intrauterine insemination — or after six months for women 35 and older.
Between the lines: The updated language applies to anyone who needs help having children, regardless of relationship status, gender identity or sexual orientation.
State of play: State law in Massachusetts already requires that insurance cover infertility diagnosis and treatment, including IVF, artificial insemination and other services.
Yes, but: Massachusetts does not require insurers to provide benefits for egg and sperm freezing, surrogacy, experimental infertility procedures or reversals of voluntary sterilization.
- People who want to have children later, who want to preserve their eggs or sperm ahead of major, life-altering surgeries and others aren't guaranteed coverage in Massachusetts.
Flashback: The ASRM stopped considering egg freezing "experimental" in 2012, and the American Medical Association started calling infertility a disease in 2017.
- These changes made way for more insurance coverage for infertility.
Reality check: The quality and range of coverage beyond the state requirements varies among employer-based insurance plans.
- And some of the nation's largest companies do not have to follow state mandates and instead follow federal insurance laws, which don't mandate fertility coverage.