Physicians, medical students face significant costs with assisted reproductive technology
Key takeaways:
- Most respondents reported using assisted reproductive technology vs. adoption or gestation carrier pregnancies.
- Those aged 32 years or older and in independent practice had higher out-of-pocket costs.
Both medical students and physicians reported incurring significant out-of-pocket costs from using assisted reproductive technology, according to study results.
The findings indicate the need for better support of medical trainees who want to build families before fertility declines, researchers concluded.
‘Adequate financial support’
“This research is important to conduct because while family building options such as assisted reproductive technology are widely known to be a major financial burden, the exact magnitude of this burden is unknown,” Morgan S. Levy, MD, MPH, physician and researcher at University of Kentucky, told Healio. “Without this information, it is challenging to ensure physicians and medical students building their families have adequate financial support for this process.”
Researchers disseminated an online survey to physicians and medical students on X, Instagram and Facebook between April and May 2021.
They evaluated self-reported out-of-pocket costs and insurance coverage for assisted reproductive technology, as well as out-of-pocket costs for gestational carrier pregnancies and adoption. Researchers grouped costs in intervals of $20,000, ranging from $0 to $20,000 and up to more than $140,000, for each family-building method used, and they stratified analyses according to age and level of medical training.
Researchers also compared costs between older vs. younger respondents and included self-identified race and ethnicity as demographic characteristics.
‘Major financial burden’
Overall, 3,104 physicians and medical students (mean age, 40.4 years; 90.7% women) completed the survey, of which 20.8% reported using assisted reproductive technology, gestational carriers and/or adoption. Most (19.3%) used assisted reproductive technology, followed by adoption (1.9%) and gestational carriers (0.9%).
Compared with those without insurance coverage, those with insurance coverage for assisted reproductive technology experienced significantly lower out-of-pocket costs (P = .005).
Data showed factors associated with experiencing higher costs included those aged 32 years and older, and those in independent practice.
“Our findings show that family building is a major financial burden for physicians and medical students,” Levy said. “Specifically, we also found that participants who had insurance coverage for assisted reproductive technology had significantly less out-of-pocket costs compared with those who did not. This finding is intuitive but encouraging to see that insurance support does achieve its intended effect.”
Study limitations included “sampling bias inherent to social media recruitment, cross-sectional data, binary age grouping likely underestimating infertility experienced by older participants, and inability to directly compare our data with the general population,” Levy and colleagues wrote.
‘Spark discussion’
Levy said she hopes the findings continue “to spark discussion about how to best support physicians and medical students building their families from a financial perspective.”
“Our data highlight cost burdens associated with assisted reproductive technology,” she said. “A key aspect of assisted reproductive technology is that for members of the LGBTQ+ community, it may be their only option to build their family, but it is a tremendous financial burden to do so. We have ongoing work looking at the family building experience of LGBTQ+ physicians and medical students and hope to highlight these disparities.”
As a current resident physician, Levy added that she has met many female resident physicians who have had children during their training.
“We have come a long way as a profession in supporting physicians who want to build their families in training, and I am hopeful that we can continue to improve the climate for family building in our profession,” she said.
For more information:
Morgan S. Levy, MD, MPH, can be reached at morganlevy@uky.edu.
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