The cost of infertility evaluation and therapy: findings of a self-insureduniversity healthcare plan

Objective: To assess the total costs of infertility coverage, determine the proportion of healthcare costs related to infertility, compare infertility costs to those of other diseases, and calculate a per member per month cos t of an infertility benefit. Design: Historical prospective analysis. Setting: A university-based, self-insured, fee-for-service healthcare plan. Patient(s): Healthcare policy members from January 1993 through December 19 95. Intervention(s): General and infertility-specific healthcare that included diagnostic tests for infertility, induction of ovulation, artificial insemi nation, donor gametes, in vitro fertilization, gamete intrafallopian transf er, zygote intrafallopian transfer, microsurgical epididymal sperm aspirati on, embryo cryopreservation, and frozen embryo transfer. Main Outcome Measure(s): Healthcare costs, as calculated from the Internati onal Classification of Diseases, Volume 9 codes. Result(s): Total healthcare and infertility-specific costs of the universit y healthcare plan over a 3-year period were $86,445,642 and $680,921, respe ctively. Therefore, infertility accounted for 0.79% of the total university healthcare costs. The mean total and infertility-specific per member per m onth healthcare costs were $86.15 and $0.67, respectively. Conclusion(s): These data reveal that infertility costs account for only a small fraction of the total healthcare costs and can be attained at a nomin al monthly fee. (Fertil Steril(R) 1999;72:778-84. (C) 1999 by American Soci ety for Reproductive Medicine.).