Evidence map›Paper›PMID 41621459›Full record

ArticleUrology2026

In Vitro Fertilization Utilization Rates and Outcomes in States With and Without Insurance Coverage Mandates for Male Infertility Care.

Amelia A Khoei, Phyllis Yan, Rodney L Dunn, David Suh, Marissa S Weiss, Kristian Black, Erica E Marsh, Edward C Norton, Vanessa K Dalton, James M Dupree

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Amelia A KhoeiDepartment of Urology, University of Michigan, Ann Arbor, MI. Electronic address: amkhoei@med.umich.edu.
Phyllis YanDepartment of Urology, University of Michigan, Ann Arbor, MI.
Rodney L DunnDepartment of Urology, University of Michigan, Ann Arbor, MI.
David SuhDepartment of Health Management and Policy, University of Michigan, Ann Arbor, MI.
Marissa S WeissDivision of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA.
Kristian BlackDepartment of Urology, University of Michigan, Ann Arbor, MI.
Erica E MarshDepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.
Edward C NortonDepartment of Health Management and Policy, University of Michigan, Ann Arbor, MI.
Vanessa K DaltonDepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.
James M DupreeDepartment of Urology, University of Michigan, Ann Arbor, MI.

Funding

Quantifying the Impact of Insurance Coverage for IVF on Maternal and Infant HealthR01HD103603 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI DUPREE, JAMES M · 2021 to 2025
$2.3M
NICHD NIH HHS R01 HD103603
6 · The paper itself

Abstract

objectiveTo compare IVF utilization rates and IVF outcomes in states with and without mandates for male infertility coverage. In 2020, 43 states recorded their lowest fertility rate in 3 decades. In-vitro fertilization (IVF) is an important treatment for couples affected by infertility, including 50% of couples with male factor infertility as a contributing cause. As of 2020, 12 states had passed laws mandating insurance coverage for IVF; only 7 of those states also mandated coverage for male infertility care.

methodsWe obtained nationwide claims data from over 91 million insured US individuals from 2003 to 2020 in Optum's de-identified Clinformatics Data Mart Database. States were categorized into 3 groups: states mandating IVF and male infertility care coverage, states mandating only IVF coverage, and all remaining states. We calculated IVF utilization rates and pregnancy, live, multiple, and preterm birth rates following IVF.

resultsIVF utilization was 6-fold higher in states with mandated male infertility coverage compared to states without any mandated coverage. Pregnancy and birth rates after IVF were similar across groups. The absolute number of births from IVF per 100,000 women was highest in states with insurance coverage mandates that included male infertility care.

conclusionIVF utilization rates and absolute number of live births from IVF were highest in states with an insurance mandate that included male infertility care. In the setting of declining fertility rates, policymakers drafting new legislation for infertility coverage should consider including coverage for male infertility care to promote family-building.

Indexed as

Fertilization in VitroInfertility, MaleInsurance CoverageAdultFemaleHumansMalePregnancyPregnancy RateUnited States

Identifiers

PMID41621459
PMCPMC13099104

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.