Let’s Get Started

By: Danielle E. Lane, M.D.

LFM_Lets_Get_StartedThe need for women to understand their reproductive options this New Year is as urgent as ever. In 2012, the Centers for Disease Control (CDC) announced that the only group to demonstrate a rise in first birth rates was women aged 40-44. Birth rates for this group/cohort have increased four-fold since 1985. Consequently, the need for increasing fertility services, mainly due to age, is at an all time high. However, while technology has provided some treatment and prevention strategies, cost remains a significant barrier to access.

Mercer, a leading benefits consultant company conducted its annual survey of employer health benefits. Survey results for 2014 indicated that nearly one third of companies with 500 or more workers do not provide coverage for infertility services. The Bay Area is unique in that high-tech companies are more likely to cover fertility benefits. Mercer found that 45% of high-tech companies cover in vitro fertilization and 27% cover other advanced reproductive procedures such as egg freezing. This is compared to non-high-tech companies with comparable figures of 26% and 14%, respectively.

In 2014, Facebook began to offer up to $20,000 in egg freezing coverage for medical or non-medical reasons for its U.S. based employees, and in 2015, Apple followed suit offering their own egg freezing benefit. And while Silicon Valley is likely providing this benefit to attract recruits in an increasingly competitive market, it still remains a critical need for women and a paradigm shift in employer health benefits.

Sadly, while companies offer the benefit, many fertility clinics refuse to contract with insurance companies. Further, many couples may be unfamiliar with the financial impact of paying cash up front and then attempting to submit their own claims, a path that may cost them thousands of dollars out of pocket.

Alternatively, some companies may offer the fertility benefit, but make access so difficult that the benefit frequently goes unused. For example, women are commonly required to undergo three to six months of subpar treatment before gaining access to more successful in vitro fertilization procedures (a concept the policies refer to as “lesser before greater”). Other companies’ policies refuse to cover single women or same-sex couples, stating that they have not attempted natural conception on their own for six to twelve months prior to requesting access to their benefit.

In the end, it will be the demands of women that drive continuous change in fertility care. Women will demand that companies not only provide benefits, but also make them easily accessible. And women will demand that fertility clinics allow them to use their benefits by choosing not to work with non-contracted providers.

Danielle E Lane, MD, Reproductive Endocrinology and Infertility specialist. Dr. Lane attended McGill University before completing her medical training at the University of Pittsburgh school of medicine, her residency at Yale-New Haven Hospital and her fellowship at the University of California, San Francisco. She opened the Center for Reproductive Health at Kaiser Permanente in Napa-Sola-no in 2005. In 2009 she founded Lane Fertility Institute. The Institute has grown to a four physician, multi location practice with a state of the art embryology laboratory. She is committed to providing education for women about preservation of their fertility and developing lower cost models to improve access to care.