State laws and regulations addressing third-party reimbursement for infertility treatment: implications for cancer survivors

Fertil Steril. 2011 Jan;95(1):72-8. doi: 10.1016/j.fertnstert.2010.05.017. Epub 2010 Jun 23.


Objective: To examine codified state policies related to infertility and assess their implications for cancer patients. Lack of insurance is often identified as a barrier to use of fertility preservation (FP) services.

Design: None.

Setting: A keyword search was developed to identify statutes and administrative regulations of insurance coverage for FP in the United States.

Patient(s): N/A.

Intervention(s): N/A.

Main outcome measure(s): Laws addressing the general population but pertaining to FP were compiled using Lexis-Nexis. Data were analyzed by reviewing the "plain meaning" of the text, legislative/administrative history, and annotated case law. Legal reasoning and common rules of statutory construction and legislative interpretation were used.

Result(s): Fifteen states (29.4%) had laws relating to insurance coverage for infertility or in vitro fertilization (IVF) procedures and two states (CA and IL) specifically excluded IVF from a mandatory offer of coverage. No state laws or regulations addressed insurance coverage for FP methods specific to cancer patients.

Conclusion(s): There is an argument for policies that require coverage for FP for cancer survivors before treatment.

MeSH terms

  • Female
  • Fertilization in Vitro / legislation & jurisprudence*
  • Health Services Accessibility / legislation & jurisprudence
  • Humans
  • Infertility, Female / etiology
  • Infertility, Female / therapy*
  • Insurance, Health, Reimbursement / legislation & jurisprudence*
  • Neoplasms / complications*
  • Pregnancy
  • State Government*
  • Survivors / legislation & jurisprudence
  • Survivors / statistics & numerical data
  • United States / epidemiology