Same-sex couples starting IVF earlier after insurance expansion in New York

NEW ORLEANS – A speaker said same-sex couples started IVF about eight months earlier next year, compared with three years before New York state required insurers to offer the possibility earlier access for non-heterosexual patients.

In February 2021, New York state expanded the definition of “infertility” to explicitly include people trying to conceive regardless of sexual orientation or gender identity. The state directs insurance companies to immediately cover infertility treatments for same-sex couples without requiring them to undergo months of fertility testing, SamantHan Estevez, MD, a fellow in reproductive endocrinology and infertility at the Icahn School of Medicine at Mount Sinai, said in a presentation at the ASRM Scientific Conference & Exposition.

“Increased insurance coverage could contribute to increased access to fertility care for same-sex couples,” Estevez told Healio.

In a retrospective cohort study, Estevez and colleagues compared the time from first consultation to IVF or co-IVF and from first consultation to pregnancy for previous same-sex couples. and after insurance extension. They reviewed patient records from a private academic fertility center on all same-sex couples who had the procedure from 2018 to 2020 (n = 250) and from 2021 to 2022 (n = 35).

The researchers found that the median time to IVF in the earlier group was 292 days compared with 173 days in the more recent group (P 0.01). Additionally, a higher percentage of the new group started IVF treatment less than 1 year after the initial consultation compared with the previous group (86% vs. 59%; P = 0.02). After adjusting for age, BMI, and anti-Mullerian hormone levels, couples started IVF an average of 250 days earlier after insurance expansion than before (95% CI, 103 -397; P 0.001). Estevez said the time from initial consultation to pregnancy did not differ significantly between groups because the number of couples in the post-expansion group was small.

“LGBTQIA+ couples have a strong desire to build a family. Our findings that same-sex female couples are increasingly using IVF services support this and demonstrate the need for continued education and outreach to this patient group as they become a larger part of the our patient population,” Estevez told Healio. “Despite the challenges LGBTQIA+ people face in building a family, equitable access to reproductive care can still be achieved by engaging in clinical, legal, and policy advocacy.”

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American Society for Reproductive Medicine Scientific Conference & Exposition