Evidence map›Paper›PMID 41111313›Full record

ArticleThe Permanente journal2025

Access to Fertility Preservation: A Policy Review on State-Level Mandates for Iatrogenic Infertility.

Priyanka Achalu, Sharon L Levine, Francis J Crosson

Abstract read
In one paragraph

Article in The Permanente journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Priyanka AchaluDepartment of Health Systems Sciences, Kaiser Permanente School of Medicine, Pasadena, CA, USA.ORCID 0000-0001-5749-8143
Sharon L LevineDepartment of Health Systems Sciences, Kaiser Permanente School of Medicine, Pasadena, CA, USA.
Francis J CrossonDepartment of Health Systems Sciences, Kaiser Permanente School of Medicine, Pasadena, CA, USA.ORCID 0009-0009-5411-5798

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFertility preservation (FP) services are a critical piece of family planning for patients with iatrogenic infertility, which is defined as infertility resulting from undergoing a gonadotoxic medical treatment or procedure. There is currently no national mandate for health care plans to cover FP services, and state mandates for coverage are quite heterogenous.

methodsBetween 2016 and 2024, 18 states have passed FP mandates that vary greatly in which diagnoses are covered, for how long the coverage lasts, and if there are additional measures impacting the coverage. Particularly as the legislative landscape around FP rapidly changes, this study aimed to analyze state-level mandates to characterize which patients have reliable access to FP services. This study analyzed state-level mandates on FP services for iatrogenic infertility to build a standardized framework that compares the language in each bill.

resultsBased on close review of each state-level mandate, the following comparison coverage factors were identified for the policy review: clinical diagnoses; type of health plan, including Medicaid; FP services mandated; the time period of coverage; maximum cost; and any religious exemptions.

conclusionKey takeaways include: nonspecific legislative language appears to cover a broader set of patients; there remains insufficient detail on storage logistics of cryopreserved tissue, if covered; most states do not cover Medicaid patients; religious exemption conditions can pose barriers for patients seeking gender-affirming care; and experimental treatments are not commonly covered.

Indexed as

Fertility PreservationHealth PolicyHealth Services AccessibilityInfertilityFemaleHumansIatrogenic DiseaseInsurance CoverageMaleMedicaidState GovernmentUnited Statesembryo cryopreservationfertility preservationin vitro fertilizationsperm cryopreservation

Identifiers

PMID41111313
PMCPMC12703539

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Registered trials

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