Abstract
OBJECTIVE: To describe older parents' attitudes and opinions about the costs and insurance coverage for IVF. DESIGN: Qualitative interview study. SETTING: Two Northern California IVF practices. PATIENT(S): Sixty women and 35 male partners in which the woman had delivered her first child after the age of 40 years using IVF. INTERVENTION(S): Two in-depth interviews over 3 months. MAIN OUTCOME MEASURE(S): Thematic analysis of interview transcripts. RESULT(S): We found that although the costs of IVF were perceived as high, even by those with insurance or who could afford them, the cost of IVF relative to other expenses in life was dwarfed by the value attributed to having a child. Women were twice as likely as men to support insurance coverage for IVF. Both men and women with complete or partial IVF insurance coverage were more likely to support insurance than those without coverage. There was a broad range of attitudes and opinions about the appropriateness of IVF insurance coverage, which addressed questions of age, gender equality, reproductive choice, whether infertility is a medical illness, and the role of personal and societal economic equity and responsibility. CONCLUSION(S): Despite a generally favorable opinion about the appropriateness of insurance coverage by those who have successfully undergone IVF treatment, the affordability of IVF remains an unresolved dilemma in the United States.