Waiting on Infertility Insurance Reform? That's Risky

The issue of insurance coverage for the diagnosis and treatment of infertility has been a hot topic for many years. Just ask the good folks at RESOLVE and the American Fertility Association, the country's primary organizations that carry the advocacy banner for fertility patients into the halls of legislators. And while there is much discussion about hopeful possibilities for the majority of patients without infertility insurance coverage, there is still far more up in the air than nailed down in reality.

This article in the WashingtonTimes illustrates how hard it has been for states to decide what is an “essential health benefit” in accordance with the 2010 Federal health care law. These decisions must be hard-wired into place – ready for sale through insurance policies – by January 2014.

As of October 10, 2012, the state of Texas has not chosen a benchmark plan If you want to follow along, the Texas Department of Insurance maintains an updated page about thedetermination of Essential HealthBenefits. From that page, you can access a chart that shows the plans being considered, on the “Updated TDI Analysis of Essential HealthBenefits Benchmark PlanOptions”. If you're either a legislative or insurance expert, you might be able to discern from the TDI website whether or not infertility treatment will be covered. If, on the other hand, you're not an expert in those areas, you could be left simply confused and frustrated.

My opinion, after nearly 20 years of helping worried patients resolve their infertility: You can put off getting pregnant for years waiting for insurance coverage to be available. Eventually, some patients find that putting off fertility treatment for years equates to forever. I've never had a patient tell me that postponing treatment, sometimes to the point of making treatment no longer an option in terms of a woman's age, was worth it. I've also never heard a new parent say that they wouldn't do whatever they did to afford treatment all over again.

If you haven't sought help but need to, don't put it off by waiting for the states to figure it out. HoustonFertility Center has financial staff who can guide you, and time is of the essence.

~ Dr. Sonja Kristiansen MD

Image: Freedigitalphotos.net

Why I'm Grateful For My Own Lab: Twins from Stolen Sperm

In the United States, we're relieved to be free of a strong government hand in private affairs like choosing to use reproductive medicine. Occasionally, though, my inbox is filled with rather frantic "Did you see this, Dr. Kristiansen?!" emails bearing news stories that remind us of why some regulations are necessary.

One such story -- about accusations of stolen sperm and unwanted fatherhood -- is coming out of Houston right now.

A young man is taking a Houston area fertility center to court, saying they never actually had his consent to use his semen for IVF that eventually impregnated a former girlfriend. This news video on Click2Houston.com has interviews of both the man -- now the father of twins -- and a representative of the fertility center.

Stories like this are fortunately rare, but they still play on the fears of fertility patients. It's understandable -- not all fertility specialists use their own labs. In fact, Houston Fertility Center's own in-house, state-of-the-art laboratory has provided embryology and related services for physicians from other clinics for years. Being able to rely on my own lab provides me and my staff with an extra layer of confidence in the fertility services we provide to patients.

While things in general are far more easy-going in the U.S. than in other countries, reputable fertility centers honor both the requirements and recommendations of existing regulatory bodies. This young man's experience clearly demonstrates one reason -- no one should be cornered into parenthood.

Rules about patient consent and the use of tissue (which includes sperm and eggs) can add a layer of cumbersome bureacracy to the IVF process. Now and then, a patient will complain, "But Dr. Kristiansen, some of these requirements seem over the top and unnecessary!" My response? I am grateful to have my own laboratory serving Houston Fertility Center, and for staff who are vigilant in maintaining compliance with regulations for the benefit and well-being of everyone involved.