Issue Brief
  1. The evaluation of fertility can start after six months if the woman is over the age of 35.

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  2. Data and research often assume cisgender identities and may not systematically account for people who are transgender and non-binary. The language used in this brief attempts to be as inclusive as possible while acknowledging that the data we are citing uses gender labels that we cannot change without misrepresenting the data.

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  3. The CDC reports the percentage of women (ages 15-49) who have ever received “infertility services” (12.7%) which also includes medical help to prevent miscarriage. We report on the percentage of adult women (ages 18-49) who have ever received medical help to become pregnant, excluding medical help once women are already pregnant.

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  4. The CDC does not track the number of births as a result of other fertility assistance, like fertility medications or IUI. However, in the 2012 CDC National Public Health Action Plan for the Detection, Prevention and Management of Infertility, they recommended the development of surveillance systems which would monitor the utilization and health outcomes of non-IVF treatment for infertility.

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  5. AZ, IA, MI, MO, NV, NC, PA, TN, and VA.

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  6. IL has a mandate to cover that applies only to group plans; however, the state’s benchmark plan includes coverage for infertility treatment, so individual plans in IL also cover these services.

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  7. The TX benchmark plan includes coverage for diagnosis of infertility, so individual plans in TX also cover this service.

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  8. “Comprehensive coverage” for ART defined by CDC as covering at least four oocyte (egg) retrievals.

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  9. Availability was judged by the number of physicians performing IVF per 1,000 reproductive age women, and utilization was calculated by number of IVF cycles per 100,000 reproductive age women.

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  10. Definitions of preconception care, basic infertility services and infertility treatment were left up to the interpretation of the respondent.

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