The National Center for Health Statistics reported that fertility rates across the country have declined from 2015 to 2020, with 43 states recording the lowest fertility rates seen in 30 years.
Most of the research and discussion around fertility care usually focuses on the woman, without much consideration in terms of helping men struggling with the same problem.
But now new research may help improve that.
In the magazine Urology, researchers found that having insurance companies cover male fertility proceduresalong with female ones, is associated with more use of IVF or IVF and a higher number of IVF babies.
Not only did states with both female and male fertility coverage see more births, but they also saw significantly better rates of couples doing IVF.
“We’ve known that fertility rates have been falling for decades,” explained Amelia Aynaz Khoei, MD, MPH, lead author of the study.
“Advocating for improved coverage for men could help families achieve desired family goals,” said Khoei, also a fourth-year urologist at Michigan Medicine.
These survey findings could also go a long way in wooing President Donald Trump expanding IVF coverage to more couples in the United States;.
Examination of male-related fertility data
With 15% of couples affected by infertility and many families unable to cover the costly associated costs, Khoei felt that looking at the male side of the issue could help reveal some useful information.
IVF, on average, costs more than $12,000, and the lack of health insurance coverage for IVF forces couples to pay the full cost themselves, the paper notes.
In vitro fertilization The procedure combines a man’s sperm and a woman’s egg to produce an embryowhich, if successful, creates an embryo which is then implanted in a woman’s uterus.
When heterosexual couples seek fertility treatment, society often assumes that the woman is having reproductive problems.
But research has shown the opposite: up to half the time, Fertility problems can come from the man in the relationship.
“Considering the lack of mandatory insurance coverage for male infertility care is critical, given that the male factor is the sole cause of infertility in one-third of infertility cases, with an additional 20% of cases having a male factor as the cause,” Khoei said.
The study was conducted by comparing IVF use and IVF outcomes in states with and without insurance mandates that cover male infertility treatments.
Procedures covered included IVF and embryo transfers, varicocele repair, sperm retrieval and vasectomy reversals.
The group looked at claims data from more than 91 million insured people in the United States from 2003 to 2020.
States were divided into three groups: states that mandated coverage of IVF and male infertility care, states that mandated only IVF coverage, and all other states that did not mandate coverage of infertility care.
From there, the research team calculated IVF use along with pregnancies that resulted in live births.
They found that IVF use was six times higher in states that required both Male and female infertility care is covered by insurance compared to states without such mandates.
Additionally, the absolute number of IVF births per 100,000 women was highest in states with insurance coverage mandates that included male infertility care.
The research team also found that IVF use and the number of IVF babies were higher in states that required coverage for both IVF and male infertility care than in states that mandated insurance coverage for IVF alone.
“These findings suggest that providing insurance coverage to help men seek infertility care allows more couples to have IVF and have more IVF-only babies,” explained James M. Dupree, MD, MPH, Professor of Urology and Obstetrics & Gynecology and the study’s senior author.
“Covering male infertility care seems to help the couple as a whole,” Dupree said.
Extending male infertility care into future insurance coverage
With declining fertility rates on the rise, Khoei urges policymakers drafting new legislation around this issue to heavily consider including men’s fertility care to help promote family building.
Patients need help to overcome structural barriers and financial vulnerability, and therein lies a world of opportunity for new legislation, Khoei says.
“Many studies show that birth outcomes improve after addressing male infertility. We are at a critical point of change. Policymakers interested in improving fertility rates and increasing the number of healthy babies born across the country should consider including insurance coverage for men to promote access to care and safe births,” said Khoei.
“Collaboration with physicians and researchers can help guide these future changes.”
Additional authors: Phyllis Yan, Rodney L. Dunn, David Suh, Marissa S. Weiss, Kristian Black, Erica E. Marsh, Edward C. Norton, Vanessa K. Dalton, and James M. Dupree.
Document referred to: “Rates and Outcomes of IVF Use in States with and without Mandates for Male Infertility Care,”Urology. DOI: 10.1016/j.urology.2026.01.034
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Previously Posted at michiganmedicine.org with Creative Commons license
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